I really need your expertise on this one.
I had a Bicillin LA shot on Friday, at noon.

I felt the usual bruising pain right after the shot, but instead of the pain going away, it slowly kept getting worse and worse. It first felt like a deep bruise, like somebody punching me in the butt.

Friday night, I had a real hard time sleeping because of the pain. It was very painful to lay down on the affected area, and very hard to get in and out of bed. Then when I woke up
Saturday morning, I could hardly walk on it.
On Saturday, it then started to feel like and inflammatory/infection type of pain. It was very hard walking around, and especially difficult getting in and out of the car.

By late Saturday afternoon, I started running a fever: 100 degrees to be exact, with some slight chills.

Again, Saturday night, it was hard to sleep very well. But throughout the night, I noticed that the pain was not as bad. I woke up a little better this morning; only a 99 degree temp., but my butt/hip is still sore, and it is still hard to get around this morning.

The whole thing is very strange. You see, all of the pain that I am having is around the hip and butt areas.
I have had hip problems for a long time now; I know it has to be Lyme related.

So, my question is, is this a herx that I am having, or is it a reaction to the penicillin. I know that some people have hypersensitivities to penicillin, which include fever and chills.
But I have not had any typical allergy symptoms: no rashes of any kind, no trouble breathing, and no stuffiness of any kind.

Some of my friends who have had these penicillin shots have never had these type of complications. Did the nurse inject the penicillin too fast? Could it be, that she used a "dirty needle"?

If it is a reaction to the penicillin, I sure need to be careful. The LA concerns me. If I do have a major reaction with this penicillin, it is not going to exit my body very quickly.

I am going to talk to Dr C about this Monday, but I would sure appreciate your opinions and suggestions.

Thanks,

DMC

I have been having widespread body pain after my shots and figure that it is a herx. I also had a slightly elevated temp after the first couple of injections.

When the pain makes it hard for me to sleep at night I take tylenol, benadryl, and relafen (a NSAID) at bedtime. I was finding that I was getting really run down between my reaction to the bicillin (like having the flu) and the impact of only sleeping 4 interrupted hours a night because of the pain.

Now I am finally having a good half day or so right before I'm due for the next bicillin dose, so I am considering that a good sign.

I have been on Bicillin for over a year and Still herx. Usually, there is a flare up of symptoms about twenty-eight hours after the shot (it reaches peak level in about twenty-four hours. Then after about three weeks in which I feel great, it happens again. Usually, this is for four of five days. Early on I would feel hot and sweaty, have an upsurge of pain in my extremeties, and a general malaise.

Dr. B. notes in his Diagnostic Hints and Treatment Guidelines that Bicillin is "surprizingly effective" but to expect "intersting" Herxheimer reactions for as long as several months. That was my experience, also

The early shots were MUCH more uncomfortable, aching and stinging for about two days. Now I basically forget about them after a couple of hours. Since you were given an antibiotic, it seems unlikely that you got a dirty needle but if you develop localized redness and heat, you probably should get it checked out.

My guess is that you are OK. Because it is slow releasing, I have heard that allergic reactions are very rare. This has been a very effective drug for me and my recovery seems like a miracle. Try drinking a Detox Tea containig danelion root. It often eases my herx symptoms within half an hour, or so. If yo try it and feel better, it almost surely is a herx. Be careful but hang in there.

From reading your responses, it is obvious to me that the muscle pain is a result of the way the shot was administered to me.

There was never any redness around the injection site.

Cave,

It was a nurse that gave me the shot.

And I do not think that the penicillin was warmed up,
And I am pretty certain that it was injected too fast.
She also did not massage the muscles after the shot.
The nurse was pretty concerned about the pain produced by the shot, so she probably injected it too fast, thinking that it would be easier on me that way.

Sounds like I am having a good response to the Bicillin!

David,
the timing of your flare-up symptoms is almost identical to what I have experienced. I started to run a fever around 28 hours after the injection.

Hudson Valley Girl,
Good luck on your progress too! I believe that you will continue to improve.

David, Cave, good luck to you as well. Continue to fight the good fight, and keep the faith.

Thanks again for the replies. I will continue to search for more posts and articles here in Lymeland on Bicillin injections.

DMC

PLUS,

you dont' ever have to worry about using a dirty needle...

all needles are mandated by law to be disposable now...ALL needles! medication needles, even acupuncture needles!! they are individually packaged adn disposable...so you never have to worry about that..k?

jsut thought I'd add that to help relax you a bit for later shots...

Lisa

In most of the world Penicillin Benzathine G (Bicillin LA generic) is sold as a powder to which sterile water is added. In Israel they mix it with 1%Lidocaine which, apparently, reduces the discomfort substantially. I haven't tried it but, if you have ever had I.M. Rocephin, it almost always is mixed with Lidocaine. I've had it without. TALK ABOUT PAIN! Bicillin is NOTHING by comparison.

Anyway, if you have had Lidocaine with no problems in the past, the Bicillin could theoretically be injected into a 5 ml syringe to which Lidocaine is added. It would create a geater volume but would also be more liquid. Bicillin LA is about the consistency of Elmer's glue.

You might ask your doctor about this. Also, did you by chance get 2.4 MU in one shot. That's a double dose and many docters specify that it be given 1/2 in each cheek.

My experience is that massaging the area caused more pain. However, it it helps, the key to the stuff as I understand it is slow-dissolving at a chemical level and therefore, the lump sould be irrelevant.

Good luck and keep us posted.

She said that sometimes there is nothing that can be done to prevent the pain from happening because the penicillin is so thick, but she did mention one thing:

that the type of syringe used could be the culprit. She mentioned transferring the bicillin from the "standard syringe" to a more "patient friendly" one. I do not remember what type of syringe she was talking about, but it makes sense.

As far as the flu-like symptoms that I am having, she said that this is a typical
die-off reaction.

Any reactions to the penicillin would have occured 20-30 minutes after the injection.

She also added that if I am not feeling better by Wednesday, to skip the next bicillin shot scheduled for this Friday.
I hope this post will help future Bicillin recipients with similar experiences.

My thanks to everyone here, and thanks for all of your suggestions.

Pediatr Infect Dis J. 1998 Oct;17(10):890-3. Related Articles, Links

Lidocaine as a diluent for administration of benzathine penicillin G.

Amir J, Ginat S, Cohen YH, Marcus TE, Keller N, Varsano I.

Department of Pediatrics C, Schneider Children's Medical Center of Israel, Petah Tikva. [email protected]

OBJECTIVE: Benzathine penicillin G is recommended for secondary prophylaxis of rheumatic fever. Its main disadvantage is local pain and discomfort associated with the injection. Lidocaine as a diluent may reduce this discomfort. We compared the administration of benzathine penicillin G with two diluents; sterile water and lidocaine hydrochloride 1% for penicillin concentrations and pain of injection. DESIGN: In a randomized double blind, crossover trial, 18 children ages 11 to 19 years who required prophylactic treatment for rheumatic fever were randomly divided into two groups. One received an injection of benzathine penicillin G diluted with 3.2 ml of sterile water, followed 1 month later by an injection of benzathine penicillin G diluted in lidocaine hydrochloride 1%; the second group received the same regimen in the reverse order. Serum penicillin concentrations and subjective pain sensation were determined after each injection. RESULTS: Peak serum penicillin concentrations at 24 h after injection were similar for both preparations (0.100 microg/ml for water, 0.102 microg/ml for lidocaine), as were the other serum values measured throughout the month. After 28 days detectable concentrations (> or =0.020 microg/ml) were found in 44 and 291% of the subjects, respectively (P = 0.4). Urine penicillin concentrations on Day 28 were 1.81 +/- 0.25 and 2.31 +/- 0.25 microg/ml, respectively. The pain score immediately after the injection was significantly lower with the lidocaine than with the sterile water dilution. CONCLUSION: Use of lidocaine hydrochloride as a diluent for benzathine penicillin G does not change the penicillin concentration in body fluids and significantly reduces the pain of injection. We suggest the use of lidocaine hydrochloride 1% as a diluent for benzathine penicillin G.

Publication Types:
Clinical Trial
Randomized Controlled Trial

quote:

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Originally posted by David95928:

One other question. If you were nervous about that first shot, you mighthave clenched up the muscle. That will make any I.M. injection painful. If you think this may have been an issue, consciously try to stay relaxed the next time. A good trick is putting all of your weight on the side not getting injected or, sometimes lying down for the shot helps.
I'll find and post an abstract on the lidocaine question.

David

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To answer your question,

no, I was not nervous about the shot, and I did have all of my weight off of the injection site side of my body.
And it was LESS painful DURING the shot, than afterwards.

next quote by David:

"Your doctor and/or the person doing your injections might be interested in this. The Bicillin would have to be transfered to a larger standard syringe."

Bingo!
That is exactly what Dr C's nurse told me today on the phone.

Thanks David.