An Evaluation of the Incidence of Reactions to Penicillin

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Abstract
The frequency and type of reactions to penicillin are tabulated in 2 studies, each involving about 20,000 venereal disease patients, carried out in 1954 and in 1959. In 1959, the patients were detained in the clinic for 30 min. after treatment to avoid risk of anaphylactic reactions occurring on the street. This was the only change in the procedure in the 2 studies. In 1954, 6 in 1000 had reactions, in 1959, 19 in 1000. Corresponding figures for anaphylaxis are 0.2 and 0.9. There was a slight increase in the urticaria rate in 1959. Reaction rate per 1000 in 1954 to procaine penicillin G in oil was 8.0, to benzathine penicillin G, 2.4. In 1959 the corresponding rates were 11.7 and 12.5. In both studies, reaction rate was many times higher in those receiving multiple treatments than in those treated in a single session, and in those who had previously reacted to penicillin than in those who had either never had penicillin before or had not reacted to it. In both studies, the rates were higher in the white race than in the negro, and in the female than in the male. Reaction rate increased significantly with age. However, this is complicated by the fact that young patients in general received lower dosage schedules, than older patients. When limited to single dose treatment the age differences are much less marked. No deaths were reported. Although the data suggest that the incidence of reactions was greater in 1959 than in 1954, Brown believes that the increase is more apparent than real partly because of the 30 min. observation after treatment in the 1959 study, which increased the number of immediate reactions observed, and also because of the higher dosage of penicillin used for gonorrhea in the later study. He concludes that the higher incidence of reactions in 1959 is in no way alarming, and that no change in present treatment practices seems to be indicated.

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