Table 1.
Clinical data of nine reported cases of severe non-allergic adverse reactions associated with Benzathine Penicillin G.
| Case | Age (years) | Gender | Indication for BPG administration | Dose (MU) | Co-administration of lidocaine | Time from BPG administration to onset of event | Background diagnoses | Description of event | Outcome |
|---|---|---|---|---|---|---|---|---|---|
| 1 | 77 | F | Recurrent erysipelas | 1.2 | Yes (1%) | < 1 min | DM2 HTN AF PVD CHF Tricuspid regurgitation Pulmonary HTN |
Loss of consciousness, asystole No accompanying symptoms | Death |
| 2 | 70 | F | Recurrent erysipelas | 2.4 (in two doses) | Yes (1%) | Seconds after 2nd dose | CHF AF Post-aortic valve replacement |
Loss of consciousness, asystole No accompanying symptoms | Death |
| 3 | 91 | F | Recurrent erysipelas | 1.2 | Yes (1%) | Seconds | IHD COPD LVH HTN Dementia AF |
Loss of consciousness, asystole No accompanying symptoms | Death |
| 4 | 66 | M | Recurrent erysipelas | 2.4 (in two doses) | Yes (1%) | Seconds after 2nd dose | Lymphoma HTN AF CHF Aortic regurgitation |
Loss of consciousness, cyanosis No accompanying symptoms | Death |
| 5 | 93 | M | Recurrent erysipelas | 1.2 | Yes (1.5%) | During injection | DM1 IHD CHF HTN PVD CRF |
Loss of consciousness, cyanosis | Underwent CPR. Subsequently recovered |
| 6 | 81 | F | Recurrent erysipelas | 1.2 | Yes (1%) | 1 h | HTN Dementia CHF IHD |
Loss of consciousness, regained spontaneously. Subsequently complained of nausea, cold sweat | Patient recovered |
| 7 | 10 | M | Prevention of RF | 1.2 | No | A few minutes | Severe mitral insufficiency Chronic endocarditis Post-RF |
Cardio-respiratory arrest | Death |
| 8 | 12 | M | Prevention of RF | 0.6 | No | Seconds | Severe mitral insufficiency AF Post-RF |
Loss of consciousness, asystole | Death (Initially regained cardiac activity, died 2 days later) |
| 9 | 87 | F | Sinusitis | 2.4 | No | Seconds | DM2 HTN AF Osteoporosis |
Loss of consciousness, vomiting, diaphoresis | Patient recovered |
Cases 1–6, reported from Israel, cases 7–9 reported from Switzerland.
AF, atrial fibrillation; CHF, congestive heart failure; COPD, chronic obstructive pulmonary disease; CRF, chronic renal failure; DM, diabetes mellitus; HTN, hypertension; IHD, ischemic heart disease; LVH, left ventricular hypertrophy; PVD, peripheral vascular disease; RF, rheumatic fever; CPR, Cardiopulmonary Resuscitation.