Rheumatic fever and rheumatic heart disease: updates for clinical practice

Rheumatic heart disease is the most common cause of acquired childhood cardiac disease globally and, in Australia, affects First Nations peoples at disproportionately high rates. Australian guidelines recommend that skin and throat infections, which can be due to Group A Streptococcus, should be managed with antibiotics in high-risk individuals to prevent rheumatic fever and rheumatic heart disease. Regular long-acting intramuscular penicillin is recommended for secondary prevention of rheumatic fever. Injections are painful and should be administered by competent clinicians using strategies and techniques for minimising pain and distress. The Australian Guideline for the Prevention, Diagnosis and Management of Acute Rheumatic Fever and Rheumatic Heart Disease (2025) includes recommendations for clinical care delivered within a cultural framework that puts the person and their family at the centre of care.