Acute rheumatic polyarthritis. The duration of secondary prophylaxis

Antistreptococcal prophylaxis was discontinued in a group of 44 children who had acute rheumatic polyarthritis with no carditis or chorea during the initial attack and who had completed a mean period of 5 years of secondary prophylaxis and freedom from recurrences. Patients were then followed up for a mean period of 5 years (an observation period of 216 patient-years). Recurrence of disease occurred in 3 patients, with a recurrence rate of 1.4 per 100 patient-years. There was no evidence of carditis during these recurrences and all patients remained free of rheumatic heart disease 10 years after the initial attack. These data demonstrate the relative safety with which continuous antistreptococcal prophylaxis can be discontinued in a selected group of children with rheumatic fever.