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Rheumatic Heart Disease Prophylaxis — RACP Paediatrics MCQ

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ModerateCommunity & Indigenous HealthRheumatic Heart Disease ProphylaxisRACP Paediatrics

A 10-year-old Aboriginal boy from a remote community in the Northern Territory is diagnosed with acute rheumatic fever (first episode with mild carditis). What is the recommended secondary prophylaxis regimen?

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Correct answer: D — Intramuscular benzathine benzylpenicillin G 1.2 MU every 28 days for a minimum of 10 years or until age 21 (whichever is longer)

RHDAustralia guidelines recommend IM benzathine benzylpenicillin G (900 mg [children <20 kg] or 1.2 MU [≥20 kg]) every 28 days as the preferred secondary prophylaxis. For ARF with mild carditis, the recommended duration is a minimum of 10 years or until age 21 years (whichever is longer). For severe or recurrent carditis, prophylaxis may continue for life.

Reference: RHDAustralia – 2024 – Australian Guideline for Prevention, Diagnosis and Management of Acute Rheumatic Fever and Rheumatic Heart Disease