Fatal Reactions to Benzathine Penicillin G

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Abstract
BENZATHINE PENICILLIN G has been used extensively in recent years, particularly in the treatment and prophylaxis of streptococcal infection and a venereal disease. The over-all reaction rate from this agent appears to be not significantly higher than from other salts of penicillin administered parenterally,as noted from the scarcity of reports of fatal reactions. Thus far, only 13 known fatalities have been recorded. If all the doses used in the United States were converted to 600,000 units, they would total more than 40 million, a roughly estimated fatality incidence of 1 per 3 million doses. The purpose of this report is to describe fatal reactions in 3 patients shortly after they had received an injection of benzathine penicillin G as an antistreptococcal prophylaxis in the management of their rheumatic heart disease. Report of Cases Case 1.—A 19-year-old male was admitted because of congestive failure. His past history was essentially negative. He

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