Guidelines for Prevention of Rheumatic Fever Updated

Prevention requires proper identification and treatment of the streptococcal infection
By A. Agrawal, PhD
HealthDay Reporter

FRIDAY, Feb. 27 (HealthDay News) -- Prevention of rheumatic fever relies on proper identification and treatment of the bacteria responsible, with penicillin being the preferred treatment, according to updated guidelines published online Feb. 26 in Circulation: Journal of the American Heart Association.

To update guidelines last published in 1995, Michael Gerber, M.D., from Cincinnati Children's Hospital Medical Center, and colleagues reviewed the current evidence for the prevention of rheumatic fever. They note that primary prevention of rheumatic fever depends on proper identification and treatment of group A β-hemolytic streptococcal tonsillopharyngitis (strep throat). Throat culture remains the standard for diagnosis, they write.

The committee recommends penicillin as a treatment due to its cost-effectiveness, proven efficacy and the current lack of penicillin-resistant strains. For patients allergic to penicillin, antibiotics such as a narrow-spectrum oral cephalosporin can be used, they note. Antibiotic prophylaxis should be used to prevent secondary recurrences, with penicillin again being the agent of choice.

"In certain areas of the United States, a few localized outbreaks in civilian and military populations were reported in the 1980s. This reappearance of acute rheumatic fever serves as a reminder of the importance of continued attention to prevention of rheumatic fever in this and other developed countries; however, currently, the overall incidence of acute rheumatic fever remains very low in most areas of the United States," the authors write.

One co-author disclosed receiving a research grant from Quidel Corp. to study rapid strep tests.

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