Acute rheumatic fever (ARF) prophylaxis refers to preventive measures that a doctor may take to stop a recurrence of ARF. These measures involve administering antibiotics to prevent infection.

ARF is an immune response to infections resulting from a type of bacteria known as group A Streptococcus (GAS). This condition can affect several different body parts and, in some cases, cause serious complications.

Preventive antibiotics can reduce the chance of ARF recurring and causing further illness.

This article discusses how doctors can use secondary preventive measures, diagnosis, and other treatments to reduce the chance of the condition recurring.

rheumatic prophylaxisShare on Pinterest
Kseniya Ovchinnikova/Getty Images

Prophylaxis, which people sometimes call secondary prevention, refers to measures that prevent a person from becoming ill with a condition. ARF prophylaxis refers to using antibiotics to prevent a person from getting ARF again after having the condition for the first time.

This is a key measure in treating ARF, as recurrence is very likely and can lead to more severe illness, including rheumatic heart disease and, in some cases, death.

Prophylaxis treatment for ARF consists of antibiotics that a person may take for a long period, sometimes for years.

Preventive antibiotic treatment may include the following:

  • regular penicillin injections
  • daily oral penicillin
  • sulfadiazine
  • macrolide antibiotics

What is acute rheumatic fever?

ARF is an inflammatory immune reaction to a GAS infection — although not everyone who has this type of infection will develop ARF. GAS infections include strep throat and scarlet fever, and ARF usually develops 2 to 4 weeks after the initial infection.

The reaction can affect multiple organs and parts of the body, including the brain, heart, musculoskeletal system, and skin. In some cases, the condition causes rheumatic heart disease, which damages the heart valves and can lead to serious complications.

ARF most commonly affects children between ages 5 and 15, but it can occur in adults and younger children in rare cases.

Symptoms include:

Learn more about rheumatic fever.

There is no definitive test that a doctor can use to diagnose ARF. Instead, they may rely on taking a medical history, assessing a person’s symptoms, and running various tests.

Diagnostic tests include:

  • a throat swab to check for a GAS infection
  • a blood test to check for evidence of a previous GAS infection
  • an electrocardiogram
  • an echocardiography

Doctors use the revised Jones criteria to diagnose ARF. This requires a doctor to identify a certain number of major and minor indications of ARF to make a diagnosis. The criteria may depend on the individual’s risk level in the location and whether they have had the condition before.

While prophylaxis is important in preventing ARF recurrence, a doctor may use other methods to treat someone with ARF. These treatments focus on reducing inflammation and relieving symptoms.

Treatments include:

A doctor may also recommend bed rest while a person has ARF, as well as maintaining hydration and eating healthily to allow the body to rest, recover from illness, and prevent further inflammation.

Without complications, ARF usually lasts for around three months before a person recovers from the illness. However, there is a 65% chance of recurrence after an initial diagnosis of ARF, and recurrence comes with an increased risk of developing rheumatic heart disease, which can potentially require surgery and lead to heart failure.

Prophylaxis can help to reduce the chance of getting ARF again, and individuals need to follow their treatment plan and advice from their doctor when taking antibiotics to prevent the condition.

Those living in areas with good access to healthcare and resources for treating and preventing ARF have a good chance of recovering from the condition without serious complications. However, those without access to these resources may be more likely to develop complications.

Diagnosing and treating initial GAS infections is the most effective way to prevent ARF. However, a person can be unaware they have a GAS infection, or clinical tests do not pick up the presence of the infection.

Good hygiene practices can help to prevent the spread of GAS infections, including:

  • regular handwashing
  • covering the mouth when coughing or sneezing
  • avoiding close contact with sick individuals
  • regularly cleaning frequently touched areas

ARF prophylaxis can be an effective way to reduce the chance of a person becoming unwell with the condition again. Regular antibiotics to prevent secondary illness are important as recurrence can lead to worsening symptoms and serious complications. However, there is still a high chance of recurrence.

Other treatments for ARF focus on reducing symptoms and inflammation and allowing the individual to recover from the condition.

Preventive measures to reduce the spread of GAS infections and treating these infections with antibiotics when possible are key for preventing ARF.