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Although the overall incidence of serum sickness is declining because of decreased use of heterologous sera and improved vaccinations, rare sporadic cases of serum sickness from nonprotein drugs such as penicillins continue to occur. Drug\u2010induced serum sickness is usually self\u2010limited, with symptoms lasting only 1\u20132 weeks before resolving. We report an unusual case of a severe and prolonged serum sickness reaction that occurred after exposure to an intramuscular penicillin depot injection (probable relationship by Naranjo score) and discuss how pharmacokinetics may have played a role. Clinicians should be familiar with serum sickness reactions particularly as they relate to long\u2010acting penicillin preparations. Accurate diagnosis in conjunction with cessation of drug exposure and prompt initiation of antiinflammatory treatment with corticosteroids can produce complete recovery.<\/jats:p>","DOI":"10.1592\/phco.26.5.705","type":"journal-article","created":{"date-parts":[[2011,3,30]],"date-time":"2011-03-30T12:16:58Z","timestamp":1301487418000},"page":"705-708","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Severe Serum Sickness Reaction to Oral and Intramuscular Penicillin"],"prefix":"10.1002","volume":"26","author":[{"given":"Brychan M.","family":"Clark","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George H.","family":"Kotti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anand D.","family":"Shah","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas G.","family":"Conger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2012,1,6]]},"reference":[{"key":"e_1_2_1_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1081-1206(10)63308-X"},{"key":"e_1_2_1_3_2","first-page":"220","article-title":"Childhood serum sickness: a case report","volume":"34","author":"Chao YK","year":"2001","journal-title":"J Microbiol Immunol Infect"},{"key":"e_1_2_1_4_2","first-page":"157","article-title":"Serum sickness syndrome","volume":"33","author":"Lin RY","year":"1986","journal-title":"Am Fam Physician"},{"key":"e_1_2_1_5_2","doi-asserted-by":"publisher","DOI":"10.1172\/JCI105494"},{"key":"e_1_2_1_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a115663"},{"key":"e_1_2_1_7_2","first-page":"1308","article-title":"Allergic reactions to long\u2010term penicillin prophylaxis for rheumatic fever","volume":"337","author":"International Rheumatic Fever Study Group","year":"1991","journal-title":"Lancet"},{"key":"e_1_2_1_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0065-2776(08)60800-7"},{"volume-title":"Bicillin L\u2010A (sterile penicillin G benzathine suspension) prescribing information","year":"1983","author":"Wyeth Laboratories","key":"e_1_2_1_9_2"},{"key":"e_1_2_1_10_2","first-page":"1126","volume-title":"Goodman and Gilman's the pharmacological basis of therapeutics","author":"Mandell GL","year":"1980"}],"container-title":["Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1592%2Fphco.26.5.705","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1592\/phco.26.5.705","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T13:46:14Z","timestamp":1761054374000},"score":1,"resource":{"primary":{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/10.1592\/phco.26.5.705"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2006,5]]},"references-count":9,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2006,5]]}},"alternative-id":["10.1592\/phco.26.5.705"],"URL":"https:\/\/doi.org\/10.1592\/phco.26.5.705","archive":["Portico"],"relation":{},"ISSN":["0277-0008","1875-9114"],"issn-type":[{"type":"print","value":"0277-0008"},{"type":"electronic","value":"1875-9114"}],"subject":[],"published":{"date-parts":[[2006,5]]},"assertion":[{"value":"2012-01-06","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}