AUTHOR=Berkovitch Matitiahu , Ashkenazi-Hoffnung Liat , Youngster Ilan , Shaniv Dotan , Dil-Nahlieli Dorit , Gorelik Einat , Schäublin Martina , Stoller Rudolf , Karra Nour , Schwartzberg Eyal 

TITLE=Fatal and Near-Fatal Non-allergic Reactions in Patients with Underlying Cardiac Disease Receiving Benzathine Penicillin G in Israel and Switzerland

JOURNAL=Frontiers in Pharmacology

VOLUME=Volume 8 - 2017

YEAR=2017

URL=https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2017.00843

DOI=10.3389/fphar.2017.00843

ISSN=1663-9812

ABSTRACT=Benzathine Penicillin G (BPG) is commonly used for treatment of penicillin-susceptible infections and secondary prevention of rheumatic fever. Death following administration of BPG is extremely rare – only a handful of cases have been described in the literature since the 1950's. In this case series from Israel and Switzerland, we describe nine cases of serious adverse reactions - six fatal reactions and three near-fatalities - occurring within minutes of receiving intramuscular BPG. Allergic reactions or faulty administration were not implicated in any of the cases; however, all patients had cardiac risk factors. This case series describes a relatively rare risk that should be borne in mind when prescribing BPG.