Oral phenoxymethyl penicillin therapy in prophylaxis of recurrent rheumatic fever.

Abstract

Prior to the advent of chemotherapeutic and antibiotic agents, streptococcal disease and its complications accounted for about 10% of deaths in the pediatric age group. Although this figure has been reduced to less than 1%, the most serious complication at present is that of acute rheumatic fever. It has been shown that this complication can be prevented by adequate treatment of the preceding streptococcal infection. 1,2 Bland and Jones 3 have demonstrated that recurrences of rheumatic fever or chorea are common and occur in approximately 20% of patients during the first five years after the initial episode of acute rheumatic fever. Although the mortality rate in the first episode of acute rheumatic fever is low, residual cardiac damage results in an appreciable mortality and morbidity in later years. 3-5 The severity of the cardiac damage is increased with each recurrence of acute rheumatic fever, and so prevention of recurrences is