skip to main content

RHD Secondary Prophylaxis Duration — RACP Adult Medicine MCQ

Instant feedback + full explanation. One question, done properly.

ModerateInfectious DiseasesRHD Secondary Prophylaxis DurationRACP Adult Medicine

A 25-year-old woman with rheumatic heart disease (moderate mitral stenosis with mild MR) on secondary prophylaxis with benzathine penicillin G has been receiving injections every 4 weeks. She had her last episode of acute rheumatic fever at age 15. She is now 25. How long should secondary prophylaxis continue?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Lifelong (has valvular disease)

Secondary prophylaxis for ARF with persistent valvular disease is recommended lifelong (or until age 40 with ongoing review) per RHDAustralia guidelines. Without valvular disease: until age 21 or 10 years after last ARF (whichever is longer). Benzathine penicillin G IM every 21-28 days (28 days is standard, 21 days in high-risk populations). In this patient with moderate MS, lifelong prophylaxis is indicated.

Reference: RHDAustralia – 2024 – Secondary Prophylaxis Guidelines; NHFA