IMPROVED LOCAL TOLERANCE TO BENZATHINE PENICILLIN G

Four types of penicillin for intramuscular injection were compared for incidence of local reaction: (1) suspension of benzathine penicillin G, 600,000 units in 1 ml; (2) benzathine penicillin G, 600,000 units, with 5 mg of prednisolone, in 1 ml; (3) benzathine penicillin G, 600,000 units, plus aqueous procaine penicillin, 600,000 units, in 2 ml; and (4) aqueous procaine penicillin, 1,200,000 units in 2 ml. A total of 320 children were evaluated at 24 hours, and the following percentages of severe local reaction were recorded for the four penicillin preparations listed: (1) 54%; (2) 9%; (3) 11.5%; and (4) 4%. The incidence of mild local reactions was the same following all four preparations, 11 to 12%. The local tolerance to benzathine penicillin G, 600,000 units, was significantly improved by combining it with either 5 mg of prednisolone, or an equal dose and volume of aqueous procaine penicillin.