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Expert Opin Drug Deliv. 2012 Sep;9(9):1099-110. doi: 10.1517/17425247.2012.702104. Epub 2012 Jun 24.

Trends in rheumatic fever: clinical aspects and perspectives in prophylactic treatments.

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  • 1Programa de Pós-graduação em Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Rua Cel. Gustavo Cordeiro de Farias, s/n, Petrópolis, CEP 59010-180, Natal-RN, Brazil.

Abstract

INTRODUCTION:

Rheumatic fever (RF), a systemic illness that may occur following Group A beta-hemolytic streptococcal (GABHS) pharyngitis in children, is a major problem in countries with limited resources. Because of its long track record and low cost, an injection of benzathine penicillin G (BPG) suspension every 3 or 4 weeks has been used as secondary prophylaxis. Despite its excellent in vitro efficacy, the inability of BPG to eradicate GABHS has been frequently reported.

AREAS COVERED:

This work reviews the possible causes of failure, as well as the inconvenience of the current prophylactic treatment of acute RF and suggests a new pharmacotherapeutic system that could replace the current one.

EXPERT OPINION:

RF is a major problem concerning only countries with limited resources and could be considered as a neglected disease. The dose regimen using BPG suspension results in failures, which could be avoided by the use of nanocarrier-based systems. To meet this ultimate goal, the research should be transposed from the laboratory scale to an industrial and clinical application level. This research should be conducted to produce a pharmaceutical dosage form that will be commercially available, consumed by and affordable for patients. However, health, environmental and socioeconomic hazards should be considered.

PMID:
22724579
[PubMed - indexed for MEDLINE]
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