RECENT DEVELOPMENTS IN THE PREVENTION OF RHEUMATIC FEVER

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Abstract
Two methods which have been successful in lowering the incidence of rheumatic fever are prevention by chemoprophylaxis of the preceding streptococcal respiratory infection and by treatment with penicillin or aureomycin once this infection occurs. The prevention of initial attacks of rheumatic fever is best accomplished by penicillin treatment of streptococcal pharyngitis for a min. period of 6 days. Since 40% of streptococcal respiratory infections are subclinical, treatment of these infections, although effective in prevention of rheumatic recurrences, is not a dependable method by itself for prevention of recurrent attacks of rheumatic fever in rheumatic subjects. Sulfadiazine prophylaxis of streptococcal infections is the method of choice in the prevention of these recurrent attacks. If streptococcal infection occurs in rheumatic subjects, penicillin treatment for a min. period of 10 days should be instituted immediately. Aureomycin treatment should be reserved for those patients unable to tolerate penicillin since aureomycin does not appear to be as effective in reducing the incidence of rheumatic fever.