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September 21, 1957


JAMA. 1957;165(3):222-224. doi:10.1001/jama.1957.02980210018005

Penicillinase, an enzyme that destroys penicillin in vivo as well as in vitro, has been used in the treatment of 42 patients who had reacted unfavorably to penicillin. The most frequent reactions consisted of fever, urticaria, pruritus, and severe arthralgia in hands, ankles, and feet. The penicillinase was usually given intramuscularly in doses of 1 million units in 2 cc. of sterile distilled water. In some cases relief followed dramatically within a few hours; in others the symptoms continued to become more severe for 24 to 48 hours after the injection. Its effects were hard to evaluate because the severity of the penicillin reactions was variable and because some patients with moderately severe symptoms recovered completely within 24 hours after treatment with a placebo. Relief from the pruritus followed promptly after the injection in nearly every case. Two patients who had severe symptoms resembling serum-sickness and did not improve after treatment with steroids and antihistaminics obtained relief promptly after administration of penicillinase. Its only side-effects were local pain and tenderness at the site of injection.