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=8 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.