Question

An 11-year-old child with a history of streptococcal pharyngitis presents you with fever and arthralgia. There is no past history of rheumatic heart disease or features of carditis or valvular disease. How often is 6,00,000 IU of benzathine penicillin recommended for prophylaxis of rheumatic heart disease?

• A. Immediately
• B. Thrice weekly lifelong
• C. Once in three weeks for 5 years or till the age of 18, whichever is longer
• D. Once in three weeks for 10 years or till the age of 25, whichever is longer

Answer 1

The Correct Option is C

The appropriate prophylaxis regimen for rheumatic heart disease, particularly in patients who have had streptococcal pharyngitis but no previous episodes of rheumatic heart disease or carditis, is to administer benzathine penicillin to prevent future episodes of streptococcal infections and their potential complications. The dosage recommended is 6,00,000 IU of benzathine penicillin administered intramuscularly. In the case of this 11-year-old child, the most suitable regimen is:

Once in three weeks for 5 years or till the age of 18, whichever is longer

This strategy aims to cover the child through the periods of highest risk of acquiring streptococcal infections and subsequently developing rheumatic heart disease, providing a balance between effectiveness and practicality in terms of frequency and duration of the prophylaxis.