An 8-year-old with rheumatic fever is being discharged from the hospital. The nurse would expect the physician to prescribe which type of medication to prevent the recurrence of rheumatic fever?
•Rheumatic fever is caused by the Streptococcus pyogenes bacteria. Patients with a history of rheumatic fever are at a high risk of recurrent Acute RF, which increases the risk of cardiac damage. To prevent the recurrence and risk of endocarditis, the patient needs to be on long-term antibiotics.
•Primary prevention for patients with an upper respiratory infection with this bacteria is the antibiotic treatment of penicillin for at least 10 days.
•Secondary prophylaxis is mandatory for all patients who have had an attack of Rheumatic Fever, whether or not they have rheumatic heart disease.
•Treatment for RH is by IM of benzathine benzylpenicillin every three weeks or oral penicillin as an alternative (the concern is noncompliance since they must take it for many years).
•Duration of treatment:
•For RF without heart disease: 5 years or until age 18 (whichever is greater).
•With carditis: 10 years.
•With more severe valve disease or value surgery: lifelong.
•Antiarrhythmics and antiemetics are not needed for the treatment of rheumatic fever.
•NSAIDs can be used to treat fever and mild pain, but they cannot prevent the recurrence of the disease.