Abstract
The chief focus of secondary prevention is antibiotic prophylaxis. This comprises long-term antibiotic therapy for individuals with acute rheumatic fever (ARF) or rheumatic heart disease (RHD), to prevent ARF recurrences triggered by recurrent group A streptococcal infections, and thereby prevent development or worsening of RHD. Standard recommendations include use of intramuscular benzathine penicillin G at least every 28days for a minimum 5-10-years period after diagnosis of ARF. Challenges include the following: programmatic delivery of this regimen, which requires effective recall systems and use of pain-minimizing techniques for injection delivery; the need for culturally and age-appropriate adherence support tailored for young people; penicillin intolerance (which is uncommon); and securing the penicillin supply, especially in low-income settings.
Original language | English |
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Title of host publication | Acute Rheumatic Fever and Rheumatic Heart Disease |
Editors | Scott Dougherty, Jonathan Carapetis, Liesl Zuhlke, Nigel Wilson |
Place of Publication | Missouri |
Publisher | Elsevier Science Ltd. |
Chapter | 11 |
Pages | 207-234 |
Number of pages | 28 |
Edition | 1 |
ISBN (Electronic) | 9780323639828 |
ISBN (Print) | 9780323754606 |
DOIs | |
Publication status | Published - 2021 |