Participants of a phase 2 study of high dose subcutaneous injections of benzathine penicillin G (SCIP) for prevention of rheumatic heart disease reported a preference for SCIP over their usual regimen. The study involved 20 young people who received 2% lignocaine followed by 13.8-20.7 mL of benzathine penicillin G (according to body weight) into the abdominal subcutaneous tissue at a Wellington clinic. Participant experiences were obtained via semi-structured interviews, using a Kaupapa Māori consistent methodology, and observations made during/after the injection, and on days 28 and 70. Low-level pain was reported on needle insertion, during injection and following injection. Discomfort and bruising on days 1 and 2 post dose was reported by some participants; however, pain was reported as less severe than with intramuscular benzathine penicillin G. Participants were relieved that injections were only required quarterly, and almost all (95%) reported a preference for SCIP over intramuscular benzathine penicillin G. Recommending SCIP as standard of care for most patients could transform secondary prophylaxis of acute rheumatic fever/rheumatic heart disease in New Zealand and internationally, concluded the study authors.
