Recommendations Comments Duration of prophylaxis: • Acute rheumatic fever without carditis: 5 years or until the age of 21 years (whichever is longer) • Acute rheumatic fever with carditis but without persistent damage (no valvular disease): 10 years or until the age of 21 years (whichever is longer) • Acute rheumatic fever with carditis and persistent damage (valvular disease): lifelong Prophylaxis: First choice: Benzathine benzylpenicillin i.m. 1,200,000 IU i.m. once every 4 weeks Second choice: Phenethicillin p.o. 250 mg twice daily If allergic to penicillin: Azithromycin p.o. 250 mg once daily
Duration of prophylaxis:
• Acute rheumatic fever without carditis: 5 years or until the age of 21 years (whichever is longer)
• Acute rheumatic fever with carditis but without persistent damage (no valvular disease): 10 years or until the age of 21 years (whichever is longer)
• Acute rheumatic fever with carditis and persistent damage (valvular disease): lifelong
Prophylaxis:
First choice: Benzathine benzylpenicillin i.m. 1,200,000 IU i.m. once every 4 weeks
Second choice: Phenethicillin p.o. 250 mg twice daily
If allergic to penicillin: Azithromycin p.o. 250 mg once daily