Pediatr. praxi. 2016;17(4):220-223 | DOI: 10.36290/ped.2016.051

Pain relief options during the intramuscular benzathine penicillin G administration

PharmDr.Kateřina Ládová, Ph.D.^1,2, PharmDr.Petra Thomson², PharmDr.Milada Halačová, Ph.D.¹, MUDr.Petr Jirák³

¹ Oddělení klinické farmacie, Nemocnice Na Homolce, Praha

² Katedra sociální a klinické farmacie, Farmaceutická fakulta v Hradci Králové, Univerzita Karlova v Praze

³ Oddělení otorinolaryngologie a chirurgie hlavy a krku, Nemocnice Na Homolce, Praha

Administration of the intramuscular injection of benzathine benzylpenicillin (benzathine PNC G) is associated with pain or discomfort,

which could lead to non‑adherence to the therapy. This risk may be even greater in children and adolescents, therefore,

it is desirable to minimize the pain, especially when medications containing benzathine PNC G alongside with other ingredients

relieving pain are not registered and commercially unavailable. This paper reviews evidence of published literature, describing

two alternatives which could be also employed in paediatric practice to alleviate the pain. Firstly, the procedure of mixing two

available medicinal products containing benzathine and procaine PNC G, secondly, the use of a lidocaine solution for reconstitution

of benzathine PNC G powder for injection. Reported evidence suggests both options are safe and does not lead to decrease

in PNC G serum concentrations. Finally, a case study is described demonstrating our clinical experience.

Keywords: benzathine penicillin G, lidocaine, pain, procaine penicillin G

Published: October 1, 2016  Show citation