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Penicillin G concentrations required for prophylaxis against Group A Streptococcus infection evaluated using a hollow fibre model and mathematical modelling

Acute rheumatic fever (ARF), an autoimmune reaction to Group A Streptococcus (Streptococcus pyogenes; Strep A) infection, can cause rheumatic heart disease (RHD). New formulations of long-acting penicillins are being developed for secondary prophylaxis of ARF and RHD.

Stability of benzylpenicillin for continuous intravenous infusions: An isotonic formulation for therapeutic use and a low-dose formulation for clinical trial

The objectives of this study were to develop a stability-indicating high performance liquid chromatography assay for benzylpenicillin in pharmaceutical fluids, and to investigate the stability of (i) isotonic citrate-buffered BPC solutions at the clinically relevant concentration of 30 mg/mL, and (ii) low concentration citrate-buffered BPC intravenous infusions (5–30 μg/mL).

Standardization of Epidemiological Surveillance of Group A Streptococcal Impetigo

Impetigo is a highly contagious bacterial infection of the superficial layer of skin. Impetigo is caused by group A Streptococcus (Strep A) and Staphylococcus aureus, alone or in combination, with the former predominating in many tropical climates. Strep A impetigo occurs mainly in early childhood, and the burden varies worldwide. It is an acute, self-limited disease, but many children experience frequent recurrences that make it a chronic illness in some endemic settings.

The risk of intramuscular haematoma is low following injection of benzathine penicillin G in patients receiving concomitant anticoagulant therapy

Our local data supports continuing intramuscular injection of BPG in patients with rheumatic heart disease receiving anticoagulant medication

A population pharmacokinetic study of benzathine benzylpenicillin G administration in children and adolescents with rheumatic heart disease

Few children and adolescents receiving BPG as secondary prophylaxis will achieve concentrations >0.02 mg/L for the majority of the time between injections

Aboriginal children and penicillin injections for rheumatic fever: How much of a problem is injection pain?

We explore young Aboriginal people's and clinicians' experience of injection pain for the 10 years of penicillin injections young people are prescribed.

Acceptability of sonicated versus unsonicated reconstituted (powdered) benzathine penicillin G for rheumatic fever prophylaxis

Powdered benzathine penicillin G (BPG) crystals vary widely in size and shape and are larger and less uniform than crystals found in pre-mixed suspensions of BPG like Bicillin ® L-A.

Controlled Human Infection for Penicillin Against Streptococcus pyogenes – a double blinded randomised trail (The CHIPS trial)

In Australia, RHD-related death and disability is the leading driver of cardiovascular inequality between Indigenous and non-Indigenous Australians.

Penicillin Levels for Rheumatic Heart Disease Study – Remote Cohort

Asha Jonathan Bowen Carapetis AM BA MBBS DCH FRACP PhD GAICD FAHMS OAM AM MBBS FRACP FAFPHM PhD FAHMS Head, Healthy Skin and ARF Prevention Executive

Increased burden of invasive group A streptococcal disease among Australian children, 2023–2024: a prospective cohort study

Global rates of invasive Group A Streptococcus (iGAS) disease surged from September 2022, exceeding pre-COVID-19 pandemic levels, showing atypical seasonality and disproportionately affecting children. We previously described the epidemiology of iGAS among Australian children from mid-2018 to end 2022 using data from the Paediatric Active Enhanced Diseases network and here provide updated clinical epidemiology for 2023 and 2024 to help inform public health strategies.