Oral penicillin is safer than injections for patients with rheumatic heart disease
For the treatment and prevention of acute rheumatic disease, benzathine penicillin G (BPG) is used. It is administered every 3-4 weeks for a long period, but its administration gives cause for concern due to fear of anaphylaxis. Patients, who are allergic to intramuscular injection of BPG, may experience a dangerous cardiac reaction. It used to be thought that death within a few minutes or hours after the injection was due to anaphylaxis.
American scientists believe that these data do not confirm the presence of signs of classical anaphylaxis, but indicate cardiovascular reactions as the cause of death that is associated with the administration of BPG. The scientists divided the patients into two groups: low-risk and high-risk groups. The low-risk group of patients without penicillin allergy or history of anaphylaxis should be treated with BPG for secondary prevention. For the high-risk group of patients, the researchers recommend to consider an oral BPG prevention, as the benefit of penicillin outweighs the potential risks.