[Is prophylaxis for acute rheumatic fever part of current practice?]

Since the sixties, the incidence of rheumatic fever has dramatically decreased. The main causes thereof are progress in the quality of housing and a decrease in the virulence and rheumatogenic potential of streptococcal strains. The primary prevention of rheumatic fever depends on approved antibiotic treatment of streptococcal pharyngitis, whether confirmed or judged likely on clinical grounds. About the secondary prevention by long action penicillins, it should be stressed that an increased level of anti-streptolysins does not support this treatment if revised clinical Jones' criteria are not met. As a matter of fact, this secondary prevention is rarely indicated at the present time in our country. However, if rheumatic fever would become epidemic again, as it happened abroad rather recently, this secondary prevention should be reactivated.