Four-Weekly Benzathine Penicillin G Provides Inadequate Protection against Acute Rheumatic Fever in Some Children

Jessica L. de Dassel, Halla Malik, Anna P. Ralph, Kate Hardie, Boglarka Remenyi, Joshua R. Francis

    Research output: Contribution to journalArticle

    Abstract

    This study aimed to identify recurrent acute rheumatic fever (ARF) episodes which occurred despite adherence to prophylactic benzathine penicillin G (BPG). Data from Australia's Northern Territory were analyzed; ARF recurrences between 2012 and 2017 diagnosed while the person was prescribed BPG were identified. Days at risk (DAR)-median and interquartile range-preceding ARF onset were calculated. The timing of BPG doses was examined for individuals with no DAR. One hundred sixty-nine ARF recurrences were analyzed; median DAR in the previous 8 weeks before ARF onset was 29. Most recurrences occurred following > 7 DAR (87%). Eight recurrences (5%) occurred despite no DAR; all were aged less than 16 years at the time of their recurrence/s. Recurrent ARF most commonly occurs after delayed BPG doses, but in some cases, receiving every prescribed BPG dose on time did not prevent recurrent ARF. A method to identify high-risk individuals before recurrent ARF is needed.

    Original languageEnglish
    Pages (from-to)1118-1120
    Number of pages3
    JournalThe American Journal of Tropical Medicine and Hygiene
    Volume100
    Issue number5
    DOIs
    Publication statusPublished - 1 May 2019

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