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Benzylpenicillin Potassium (PCG) is effective for infectious endocarditis (IE) but it is necessary to exercise caution when prescribing it for patients. This is because one bottle of PCG contains 1.7 mEq of potassium. We investigated the use of PCG in eight patients to whom it was prescribed for IE from April 2000- October 2003 and examined the occurrence of angialgia. One patient could not be continuously administered with PCG, and the other seven patients received 12 to 20 million units for an average of 33.6 days. Following the administration of PCG, inflammation reactions subsided and no electrocardiogram abnormalities due to aggravation of kidney dysfunction or rise in serum potassium levels, or other adverse reactions were observed. Angialgia was observed in three patients, and was not relieved in two of them when the rate of medication was reduced.Though the pH of a PCG solution does not change with its concentration, the osmotic pressure rises as the concentration increases. An increase in osmotic pressure was considered to be a cause of the angialgia. It is therefore important for the pharmacist to use concentrations of PCG that do not cause angialgia in medication plans for patients with IE, so that their quality of life may be improved.

Investigation on Use of Benzylpenicillin Potassium for Infectious Endocarditis and Occurrence of Angialgia