Poster Presentation 20th Lancefield International Symposium on Streptococci and Streptococcal Diseases 2017

The benzathine penicillin G (BPG) reformulation preferences study - towards a new penicillin for rheumatic fever and rheumatic heart disease (#230)

Dianne Sika-Paotonu 1 , Ramona Tiatia 2 , Yun K Sung 3 , Lynette Lander 1 , Tia Haira 1 , Craig Thornley 4 , Bryan Betty 5 , Ranei Wineera-Parai 6 , Barbara Eddie 4 , Michael Baker 2 , Keith Chrzan 7 , Margaret Maloney 8 , Manuel Sanchez-Felix 8 , Jonathan Spector 8 , Jonathan Carapetis 9
  1. Victoria University of Wellington, Wellington, New Zealand
  2. University of Otago, Wellington, New Zealand
  3. RT & YKS Group, Auckland, New Zealand
  4. Regional Public Health, Wellington, New Zealand
  5. Porirua Union Community Health , Wellington, New Zealand
  6. Compass Health, Porirua, Wellington, New Zealand
  7. Sawtooth Software, Utah, United States of America
  8. Novartis Institutes of Biomedical Research, Cambridge, Massachusetts, United States of America
  9. Telethon Kids Institute, Perth, Australia

Acute rheumatic fever (ARF) is an autoimmune condition caused by untreated Group A Streptococcal (GAS) infection of the upper respiratory tract (and possibly skin). Multiple or severe attacks of ARF can cause cardiac damage known as rheumatic heart disease (RHD). The most effective recommended treatment of ARF requires monthly intramuscular injections of Benzathine Penicillin G (BPG) known as secondary prophylaxis. The goal of secondary prophylaxis is to prevent GAS infections that may lead to the recurrence of ARF. Rates of adherence to secondary prophylaxis schedules are usually low due to the frequency, duration, pain of injection, and access to proper and timely healthcare services. A less painful and longer acting BPG formulation would ideally help prevent ARF recurrence and improve compliance rates to this schedule. The purpose of this work is to explore the BPG reformulation preferences of children and teens currently receiving monthly BPG intramuscular injections, in addition to their families and healthcare providers. A software application has been developed that will explore the experiences of the groups who will then choose their ideal BPG formulation from a range of plausible formulations and associated dosing regimens. The software application has been optimized for use to ensure age and cultural appropriateness, and also efficient data collection. Pretesting of the software has been undertaken and interviewing of children, teens and family members has commenced. This is the first time a software application has been successfully developed to collect qualitative and quantitative data on individual preferences for BPG formulations and dosing regimens.