Effect of storage of penicillin-G solutions on sensitisation to penicillin-G after intravenous administration

Lancet. 1982 May 1;1(8279):986-8. doi: 10.1016/s0140-6736(82)91991-2.

Abstract

Intravenous administration of a total dose of more than 200 million IU of penicillin-G led to sensitisation of lymphocytes and formation of specific anti-penicilloyl antibodies of the IgG class. These effects were prevented when the penicillin solution used was freshly prepared and given as a bolus rather than as a slow infusion. The causative antigens seem to be related not to penicilloylated high molecular weight impurities in the penicillin preparations, but to the degradation and/or transformation products of penicillin-G that form when the drug is in solution even if only for a few hours, and not only at room temperature but also at 4 degrees C. Thus penicillin solutions should be freshly prepared and administered from vials containing less than 10 million IU so that bolus doses can be given.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial

MeSH terms

  • Adult
  • Drug Hypersensitivity / etiology*
  • Drug Storage
  • Female
  • Humans
  • Immunoglobulin E / analysis
  • Immunoglobulin G / analysis
  • Injections, Intravenous
  • Kinetics
  • Lymphocyte Activation
  • Male
  • Middle Aged
  • Penicillin G / administration & dosage
  • Penicillin G / adverse effects*
  • Penicillin G / metabolism
  • Radioallergosorbent Test

Substances

  • Immunoglobulin G
  • Immunoglobulin E
  • Penicillin G