Re-emphasizing Secondary Prophylaxis on Acute Rheumatic in Resources Poor Settings

Failure of secondary prophylaxis with erythromycin in rheumatic heart disease.

BACKGROUND Erythromycin is recommended for secondary prophylaxis in children with rheumatic heart disease, who are allergic to penicillin. CASE CHARACTERISTICS A 9-year-old girl, with rheumatic heart disease, on secondary prophylaxis with erythromycin 250 mg BD, presented with acute rheumatic fever. OUTCOME Responded to steroids and started on a higher dose (250 mg TDS) of erythromycin for ...

Secondary prophylaxis in rheumatic fever: is it time to change?

Background Carditis and rheumatic chronic heart disease are the most serious complications of Acute Rheumatic Fever. Nowadays prevention of recurrent episodes of group A b-hemolytic streptococcal pharyngitis is the most effective method to prevent the development of severe rheumatic heart disease. However the evidence of these guidelines are weak and result from studies conducted more than 50 y...

Determinants of poor adherence to secondary antibiotic prophylaxis for rheumatic fever recurrence on Lifou, New Caledonia: a retrospective cohort study

BACKGROUND Incidence of acute rheumatic fever (ARF) and prevalence of rheumatic heart disease (RHD) in the Pacific region, including New Caledonia, are amongst the highest in the world. The main priority of long-term management of ARF or RHD is to ensure secondary prophylaxis is adhered to. The objectives of this study were to evaluate rates of adherence in people receiving antibiotic prophylax...

Prophylaxis of rheumatic fever.

Prophylaxis of rheumatic fever.

G ROUP A streptococcal infection initiates acute rheumatic fever; rheumatic valvular heart disease is a sequela that develops during or subsequent to the acute rheumatic episode. The mechanism by which the preceding streptococcal infection produces the arthritic and constitutional symptoms and valvular heart disease is unknown. Regardless of the mechanism involved, there is little doubt that pr...