Instructions
1. Treat rheumatic fever by eliminating the GAS pharyngitis, suppressing inflammation caused by the immune system and providing supportive care for congestive heart failure.
2. Use oral penicillin V as the drug of choice for treatment of GAS pharyngitis. A single intramuscular injection of benzathine penicillin G is also effective. Administer erythromycin or a first-generation cephalosporin for patients who are allergic to penicillin. Alternatives include azithromycin for five days, clarithromycin or a narrow-spectrum first-generation cephalosporin for ten days.
3. Repeat a ten day course of the same antibiotic for recurrent GAS pharyngitis
4. Consider surgery to correct heart valve insufficiency caused by rheumatic fever. This is commonly required as a lifesaving measure since 40 percent of patients with acute rheumatic fever develop mitral stenosis as adults. A mitral valve replacement, mitral valvulotomy or percutaneous balloon valvuloplasty may be indicated in patients with critical stenosis.
5. Replace the mitral valve as the preferred surgical option in recurring cases of rheumatic fever for patients with annuloplasty or other repairs.
Tags: rheumatic fever, patients with, first-generation cephalosporin, mitral valve, percent patients