Rheumatic fever prophylaxis by long acting penicillin: reevaluation of diagnosis and regimen

ABSTRACT

Rheumatic fever is a great problem specially in developing countries including Egypt. Although the use of long acting penicillin [LPA] has been of great benefit for the prevention of its occurrence and recurrence, yet it has been not evaluate to the best of our knowledge in our area. The objective of the present study was to evaluate the diagnosis of rheumatic fever patients receiving LAP and to assess the effectiveness of different prophylaxis schedule. One hundred twenty four subjects previously diagnosed as rheumatic fever and maintained on LAP were followed for at least six months. In addition to routine clinical, laboratory and radiological assessment, EGG and echocardiography were done to all subjects. Rheumatic fever was documented in only 19% of the studied group of whom twenty two patients [92%] were proved by echocardiography to have rheumatic valve disease. Mitral regurge was the most common valve affection [58%]. LAP injection given on two weeks interval has proved to be the more effective schedule than 3 or 4 weekly injection