Development of a sustained release implant of benzathine penicillin G for secondary prophylaxis of rheumatic heart disease

Regular intramuscular (i.m.) benzathine penicillin G (BPG) injections have been the cornerstone of rheumatic heart disease (RHD) secondary prophylaxis since the 1950s. Patient adherence to IM BPG is poor, largely due to pain, the need for regular injections every 3-4 weeks and health sector delivery challenges in resource-limited settings. There is an urgent need for new approaches for secondary prophylaxis, such as an implant which could provide sustained penicillin concentrations for more than 6 months.

Citation:
Barr RK, Barber BW, Tait JR, …… Salman S, Musk GC, ……. Kado J, Manning L, Carapetis JR, Boyd BJ. Development of a sustained release implant of benzathine penicillin G for secondary prophylaxis of rheumatic heart disease. Eur J Pharm Biopharm. 2023;189:240-50.

Keywords:
Benzathine penicillin G; dissolution, in vivo release; polycaprolactone; rheumatic heart disease; secondary prophylaxis, long acting implant

Abstract:
Regular intramuscular (i.m.) benzathine penicillin G (BPG) injections have been the cornerstone of rheumatic heart disease (RHD) secondary prophylaxis since the 1950s. Patient adherence to IM BPG is poor, largely due to pain, the need for regular injections every 3-4 weeks and health sector delivery challenges in resource-limited settings. There is an urgent need for new approaches for secondary prophylaxis, such as an implant which could provide sustained penicillin concentrations for more than 6 months.