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ARF prophylaxis – penicillin allergy — RACP Paediatrics MCQ

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HardIDARF prophylaxis – penicillin allergyRACP Paediatrics

A child with a rheumatic fever history on secondary prophylaxis develops a penicillin allergy (non-anaphylactic rash). What alternative prophylactic antibiotic can be used for ARF secondary prevention?

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Correct answer: A — Amoxicillin

For penicillin-allergic patients with ARF requiring secondary prophylaxis, oral erythromycin is the standard alternative per the 2020 Australian ARF/RHD Guideline. Some guidelines suggest azithromycin as an alternative. For anaphylactic penicillin allergy, specialist allergy assessment and potentially penicillin desensitisation should be considered given the critical importance of prophylaxis.

Reference: RHDAustralia – 2020 – Australian Guideline for ARF and RHD