Psychotic-like reaction to procaine penicillin G

Area of Science:

• Pharmacology
• Neuroscience
• Clinical Medicine

Background:

• Penicillin G, a widely used antibiotic, is administered via intramuscular injection.
• Procaine penicillin G is a specific formulation designed for prolonged release.
• Adverse reactions to antibiotics can range from mild to severe.

Observation:

• A patient exhibited acute psychotic-like symptoms immediately post-intramuscular procaine penicillin G administration.
• Symptoms included metallic taste, dizziness, tinnitus, and intense fear of death.
• No significant cardiovascular or pulmonary changes were observed during the event.

Findings:

• The patient's reaction was transient, with complete symptom resolution within 15 minutes.
• No recurrence of symptoms was reported by the patient.
• This case represents a rare, immediate neuropsychiatric adverse effect of procaine penicillin G.

Implications:

• Highlights the importance of monitoring for unusual neuropsychiatric reactions to penicillin G formulations.
• Suggests a potential for rapid, transient central nervous system effects with procaine penicillin G.
• Underscores the need for clinicians to be aware of the full spectrum of potential adverse drug reactions.