Secondary prophylaxis for rheumatic fever: simple concepts, difficult delivery.

[acute rheumatic fever]

Registers of those with rheumatic heart disease or a history of acute rheumatic fever (RF ) are key to prevent RF recurrences and improve disease control . Randomized controlled trials show intramuscular long -acting benzathine penicillin G is more effective than oral penicillin to prevent recurrences . Although some guidelines recommend three -weekly benzathine penicillin , four weekly is effective if compliance rates are high . Four -weekly penicillin delivery is also preferable to three -weekly regimens for health resource and logistical reasons and for patient acceptability and compliance .