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ARF secondary prophylaxis — RACP Paediatrics MCQ

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ModerateCardiologyARF secondary prophylaxisRACP Paediatrics

A 10-year-old Aboriginal child in the Northern Territory is diagnosed with a first episode of acute rheumatic fever with polyarthritis and elevated inflammatory markers but no carditis on echocardiogram. After acute treatment, what is the most important ongoing management?

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Correct answer: E — IM benzathine penicillin G

Secondary prophylaxis with regular IM benzathine penicillin G (every 28 days or 21 days in high-risk settings) is the cornerstone of ARF/RHD management. Per the 2020 Australian ARF/RHD Guideline (RHDAustralia), prophylaxis duration is minimum 10 years or until age 21 for ARF without carditis, and longer with carditis.

Reference: RHDAustralia – 2020 – Australian Guideline for ARF and RHD (3rd edition)