BENZATHINE PENICILLIN G SHORTAGE IN BRAZIL AND RHEUMATIC FEVER PROPHYLAXIS

Introduction and Objective: Rheumatic Fever (RF) causes the most prevalent acquired heart disease in children and young adults in Brazil. Benzathine penicillin G (BPG) is the first option for RF prophylaxis worldwide. BPG shortage was reported in many countries, but not in Brazil until recently. We aim to gather information about Brazilian BPG shortage crisis and the consequences for primary care patients. Methods: Finding information on media and Internet through searching tools (Google) for news agencies and major sites related to public health, as Brazilian Ministry of Health (MOH), National Health Surveillance Agency (ANVISA), Federal Official Gazette (FOG); sites of medical associations and Councils, and from RF reference centers about new cases/ attacks. Results and Conclusion: Since 2014 a shortage of raw material imports for BPG production was announced by the industry and patients denounced BPG lack in pharmacies/ health services. Laboratories authorized to produce BPG do not deliver requested orders. Brazilian Society Infectious Diseases asked MOH measures due to congenital syphilis (CS) epidemic. “Fantástico Program” Globe Channel reported about. FOG reaffirmed BPG first choice for CS prevention, but not for RF. In Rio primary care centers were oriented to treat only syphilis with BPG. ANVISA disqualified the new Chinese supplier of raw material for not presenting Certificate of Good Practices. Reference centers from many states refer acute RF/ severe carditis, both new cases as new attacks for cronic patients and with valve prothesis. BPG shortage crisis seems not solved and should compromise RF control in Brazil.