Pharyngitis secondary prevention

Secondary prevention of pharyngitis is crucial in patients who have developed acute rheumatic fever (ARF), rheumatic heart disease (RHD) or post streptococcal glomerulonephritis, as they are at high risk for recurrent ARF and progressive RHD with subsequent episodes of group A streptococcal pharyngitis. Therefore, strategies for secondary prevention of disease recurrence are necessary to reduce morbidity and mortality in patients with a history of ARF and/or RHD.

Secondary prevention for pharyngitis is necessary to reduce morbidity and mortality in patients with a history of ARF and/or RHD. A course of antibiotic therapy should be initiated at the time of diagnosis of rheumatic fever and then a prophylactic regimen should be initiated as secondary prevention which includes intramuscular benzathine penicillin G every 3–4 weeks or twice-daily oral penicillin is preferred. If the patient is penicillin-allergic, use sulfadiazine or macrolides.

Prophylaxis is continued into adulthood and the duration of prophylaxis depending on the severity of carditis, if present.^[1]