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Evaluating the minimum active concentrations of penicillin G and V and of retard forms in clinical conditions
Abstract:
Following several signals indicating the inefficiency of the clinical treatment with various penicillin preparations in some cases, we decided to study the seric penicillin concentrations in the patients hospitalized in the "V. Babes" Hospital of Infectious Diseases, after administration of the various Romanian made forms of penicillin currently used in the therapy of streptococcal infections and in the prophylaxis of the sequelae of these infections. The data obtained on groups exceeding 30 persons by using two methods of determining the penicillin concentrations the dilutions and the diffusimetric methods revealed protective penicillin seric levels satisfactory for penicillin G and Efitard, according to the present treatment schemes. After 5 days from Moldamin administration only 45.4% of children and 43.3% of adults were found to have satisfactory penicillin concentrations. The administration of penicillin V reaches active penicillin concentrations in terms of the dose administered. The paper points out only one of the causes which together with others (such as beta-lactamase production and tolerance), contribute to the unsuccessful treatment with various forms of penicillin.
Insights
Penicillin treatment for streptococcal infections shows variable effectiveness. While Penicillin G and Efitard achieved satisfactory levels, Moldamin had suboptimal concentrations in over half of patients, indicating potential treatment failures.
Area of Science:
- Pharmacology
- Infectious Diseases
- Clinical Microbiology
Background:
- Clinical observations suggest inconsistent efficacy of various penicillin preparations for streptococcal infections.
- Penicillin remains a cornerstone for treating streptococcal infections and preventing sequelae.
Purpose of the Study:
- To evaluate serum penicillin concentrations in patients receiving different Romanian-manufactured penicillin formulations.
- To correlate serum penicillin levels with treatment outcomes in streptococcal infections.
Main Methods:
- Serum penicillin concentrations were determined using dilution and diffusimetric methods.
- Study involved patient groups exceeding 30 individuals.
Main Results:
- Penicillin G and Efitard demonstrated satisfactory serum levels according to current therapeutic schemes.
- Moldamin administration resulted in inadequate penicillin concentrations in 45.4% of children and 43.3% of adults after 5 days.
- Penicillin V achieved active concentrations relative to the administered dose.
Conclusions:
- Suboptimal serum penicillin concentrations, particularly with Moldamin, may contribute to treatment failures.
- Factors like beta-lactamase production and patient tolerance also play a role in penicillin treatment outcomes.