Secondary Prevention of Acute Rheumatic Fever and Rheumatic Heart Disease

Jessica L. de Dassel, Diana Lennon, Scott Dougherty, Anna P. Ralph

Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review

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 languageEnglish
Title of host publicationAcute Rheumatic Fever and Rheumatic Heart Disease
EditorsScott Dougherty, Jonathan Carapetis, Liesl Zuhlke, Nigel Wilson
Place of PublicationMissouri
PublisherElsevier Science Ltd.
Chapter11
Pages207-234
Number of pages28
Edition1
ISBN (Electronic)9780323639828
ISBN (Print)9780323754606
DOIs
Publication statusPublished - 2021

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