Antibiotic prophylaxis for Acute Rheumatic Fever
For how long does a patient with Acute Rheumatic Fever need antibiotic prophylaxis?
Duration of prophylaxis varies on prior manifestations of ARF. Patients with a history of ARF without cardiac involvement should receive antibiotic prophylaxis for 5 years after the last attack or to age 21 (whichever is longer). Patients with a history of mild cardiac involvement (and no residual damage/valvular disease) should be on prophylaxis for 10 years or to age 21. Patients with a history of severe carditis (including residual damage) should receive antibiotics for 10 years or to age 40, with consideration for lifelong prophylaxis. An ARF patient, even without cardiac involvement, who has frequent exposure to children (parent, day-care worker, healthcare professional, etc.) should receive prophylaxis for as long as the exposure continues.
