Cardiovascular Pharmacology: Open Access

Abstract

Penicillin use and its Impact for the Secondary Prevention of Rheumatic Fever/Rheumatic Heart Disease in a Tertiary Hospital in South Africa

Makrexeni ZM

Introduction: Acute rheumatic fever (ARF) is a post infectious, non-suppurative sequela of pharyngeal infection with streptococcal pyogens, or group a beta haemolytic streptococcus. Rheumatic heart disease (RHD) is a condition of global health importance. It is estimated that 15.6-19.6 million people are living with RHD, with almost 80% of those residing in low and middle income countries.

Methods: This was a retrospective review of records of paediatric patients with rheumatic fever and rheumatic heart disease at a tertiary hospital in South Africa; from January 2008 to December 2015. Records were analyzed for the evidence of use of secondary prophylaxis with enzathine penicillin and recurrence of rheumatic fever.

Results: Total of 60 patients was seen over the period of 8 years. Fifty seven patients presented with chronic rheumatic heart disease. Only 3 patients presented with acute rheumatic fever. All the patients in the cohort were on secondary prophylaxis with either oral or intramuscular benzathine penicillin according to the protocol. Of the 60 patients over the period of 8 years, none of the patients developed recurrent rheumatic fever on secondary prophylaxis. Twenty four were operated for rheumatic valvular heart disease.

Conclusion: Secondary prophylaxis with benzathine penicillin is effective in preventing recurrent rheumatic fever/ rheumatic heart disease. In our cohort none of the patients who were on prophylaxis developed recurrent rheumatic fever.