Aortic Valve Replacement and Penicillin Desensitization in a Patient with Abiotrophia defectiva Aortic Valve Endocarditis
Table 2
Rapid oral phenoxymethylpenicillin desensitization protocol for adults.
Step (at 15-minute intervals)
Phenoxymethylpenicillin suspension (mg/mL)
Volume (mL)
Dose (mg)
Cumulative dose (mg)
1
0.5
0.1
0.05
0.05
2
0.5
0.2
0.1
0.15
3
0.5
0.4
0.2
0.35
4
0.5
0.8
0.4
0.75
5
0.5
1.6
0.8
1.55
6
0.5
3.2
1.6
3.15
7
0.5
6.4
3.2
6.35
8
5.0
1.2
6
12.35
9
5.0
2.4
12
24.35
10
5.0
4.8
24
48.35
11
50
1
50
98.35
12
50
2
100
198.35
13
50
4
200
398.35
14
50
8
400
798.35
15
Observe for 30 minutes; if no reaction occurs, administer phenoxymethylpenicillin 500 mg orally or benzylpenicillin 1.2 g intravenously. Start therapy with the required drug at the standard dosage for the indication.
Source: eTG complete by Therapeutic Guidelines [Internet]. Melbourne (Vic):Therapeutic Guidelines Ltd.; 2020, available at https://tgldcdp.tg.org.au/etgcomplete accessed April 18, 2020.
