MONITORING EFFICACY OF BENZYLPENICILLIN IN DIPHTHERIA PATIENTS BASED ON VALIDATED HEMATOLOGICAL ANALYZER IN HODEIDAH OUTBREAK, YEMEN

Mohammed Amood AL-Kamarany* and Ahmed Majam

ABSTRACT

Background: Benzylpenicillin (penicillin G) is the chemotherapeutic agent that uses to treat the diphtheria, monitoring efficacy of benzylpenicillin takes many forms (monitoring of antibiotic concentration, monitoring of laboratory tests, monitoring of biochemical markers as a response to treatment and /or toxicity, and monitoring clinical response to treatment. Objective: Therefore, the study aims to validate laboratory test namely hematological analyzer for monitoring the efficacy of benzylpenicillin for diphtheria treatment in Hodeidah outbreak, Yemen, 2018. Materials and Methods: The hematological analyzer (Sysmex KX-21) was validated by assessment of the linearity, accuracy, precision and quantification limit of different blood samples and used for samples research analysis namely monitoring the efficacy of benzylpenicillin. 09 patients in the study were provided by informed consent. The patients were diagnosed with diphtheria according to national standard and they received benzylpenicillin 50 I.U / kg daily for two weeks. The white blood cell (WBC) and related parameters namely lymphocytes, monocytes, neutrophils, basophils, and eosinophils were monitored in three phases pre treatment, within treatment, and post treatment of diphtheria patients. On the other hand, monitoring efficacy of benzylpenicillin based on in vitro assay was carried out. Obtained data were analyzed by on appropriate statistical tools. Results: The results of validated method were precise to each analyte with percent relative standard deviation (RSD %) of precision namely < 5.0 % for WBC and < 16.0 % for neutrophils. Furthermore, the accuracy of validated method exhibited well recovery value of (97 – 103 %) and the coefficient correlation (R2) value was more than 0.9995 as a good linear method. On the other hand, the results showed the level of WBC (×109/L), and neutrophils (%) with benzylpenicillin in 77/90 cases (85.55 %) to reduce significantly from 20.2 ± 5 (×100/L), 80 ± 10 (%) pretreatment phase into 9.1 ± 5 (×109/L), 65 ± 5 (%) in post – treatment phase (p < 0.05).respectively. The result of level of WBC and neutrophils in follow up phase were 6.2 ± 2 (×109/L), 45 ± 5 (%). Conclusion: The hematological parameters means of this study namely WBC and neutrophils were economical indicator for monitoring the efficacy of antibiotic, where WBC and neutrophils increased with diphtheria infection and reduction with antibiotic administrated to normal rang were found. Briefly, the benzylpenicillin has effectiveness against diphtheria.

Keywords: Monitoring, Efficacy, Benzylpenicillin, Diphtheria, Validation, Hematological.