Pharyngitis secondary prevention

Pharyngitis Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Pharyngitis from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Diagnostic study of choice
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
Chest X Ray
CT
Ultrasound
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Pharyngitis secondary prevention On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Pharyngitis secondary prevention All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Pharyngitis secondary prevention
CDC on Pharyngitis secondary prevention
Pharyngitis secondary prevention in the news
Blogs on Pharyngitis secondary prevention
Directions to Hospitals Treating Type page name here
Risk calculators and risk factors for Pharyngitis secondary prevention

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Venkata Sivakrishna Kumar Pulivarthi M.B.B.S [2]

Overview

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

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.

Severity of Rheumatic fever with carditis	Prophylactic management
Patients with ARF but without carditis	Prophylaxis for at least 5 years or until 21 years of age (whichever is longer)
Patients with ARF associate with carditis but without any residual valvular disease	Prophylaxis for at least 10 years or until 21 years of age (whichever is longer)
Patients with ARF associate with carditis and residual valvular disease	Prophylaxis for at least until 40 years of age