Rheumatic fever primary prevention


 * Lance Christiansen, D.O.; Associate Editor(s)-in-Chief: ;

Overview
Treatment of streptococcal pharyngitis with appropriate antibiotics most often prevents development of rheumatic fever.

Primary Prevention
Most streptococcal pharyngitis when treated with appropriate antibiotics prevents acute rheumatic fever. Unfortunately, at least one third of episodes of acute rheumatic fever result from inapparent streptococcal infections. In addition, some symptomatic patients do not seek medical care. In these instances, rheumatic fever is not preventable. The key to primary prevention is reducing exposure to group A streptococci, which requires dramatic improvements in housing, hygiene infrastructure and access to health care for individuals in the developing countries.

Intramuscular benzathine penicillin G and oral penicillin V are the recommended antibiotics in treatment of group A streptococcal infection in absence of penicillin allergy. Patients who are allergic to penicillin should be treated with narrow-spectrum cephalosporin.