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Rheumatic fever chemoprophylaxis in adults
S Krishnaswami1, G Joseph, S T Chandy
1Department of Cardiology, Christian Medical College Hospital, Vellore.
The Journal of the Association of Physicians of India
|August 3, 2002
Summary
For adults over 26 with rheumatic valvular disease, stopping penicillin prophylaxis showed a very low rheumatic fever recurrence rate (0.21%). Long-term chemoprophylaxis should be considered individually for this patient group.
Area of Science:
- Cardiology
- Rheumatology
- Infectious Disease
Background:
- Rheumatic valvular disease (RHD) often requires long-term management.
- Current guidelines often recommend prolonged chemoprophylaxis for RHD patients.
Purpose of the Study:
- To evaluate the recurrence rate of rheumatic fever in adult RHD patients over 26 years old after discontinuing benzathine penicillin prophylaxis.
Main Methods:
- A cohort of 2340 adult patients with RHD (age > 26) had their benzathine penicillin injections discontinued.
- Patients were monitored for rheumatic fever recurrence over 1-9 years (mean 3 years).
Main Results:
- Only 5 patients (0.21%) experienced rheumatic fever recurrence.
- This indicates a very low risk of recurrence in this specific demographic.
Conclusions:
- Discontinuing long-term benzathine penicillin prophylaxis in RHD patients over 26 years old is associated with a low risk of rheumatic fever recurrence.
- Chemoprophylaxis decisions for RHD patients over 26 should be individualized based on risk assessment.