A NEW CONCEPT IN THE TREATMENT OF PENICILLIN REACTIONS: USE OF PENICILLINASE

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Abstract
Penicillinase is an enzyme synthesized by various bacteria. It destroys penicillin as such by hydrolyzing it to penicilloic acid. Initial in vivo studies on guinea pigs and humans who had received penicillin revealed that less than an hour after a parenteral injection of penicillinase no circulating penicillin could be detected. This highly specific action of penicillinase was utilized in this study in the treatment of patients with penicillin reactions. Forty-six patients with penicillin reactions were treated with penicillinase. Twenty-four of these patients were treated with intramuscular penicillinase alone, with uniformly good results. The other 22 patients had previously received or were given concomitant therapy with various antihistamines and/or ACTH and steroids. In 20 of these patients the favorable clinical response seemed to be directly attributable to the penicillinase. It is interesting to note that in the 2 cases with a poor response, the penicillinase was given weeks to months after the reaction started. Also in one case that could be classified as only a fair response the penicillinase was given 2 weeks after the onset of the reaction. No systemic toxic reactions to single or multiple injections of penicillinase were noted. A few patients complained of pain at the site of injection, and one patient had a local reaction with induration which may or may not have been due to the enzyme. No local or systemic toxic effects were noted in the 20 patients and many guinea pigs reported in the initial study.

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