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Treatments and drugs
By Mayo Clinic staffThe goals of treatment for rheumatic fever are to destroy any remaining group A streptococcal bacteria, relieve symptoms, control inflammation and prevent recurring episodes of rheumatic fever.
Treatments used for rheumatic fever include:
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Antibiotics. Your child's doctor will prescribe penicillin or another antibiotic to eliminate any remaining strep bacteria that may exist in your child's body.
After your child has completed the full antibiotic treatment, your doctor will begin another course of antibiotics to prevent recurrence of rheumatic fever. This preventive treatment usually continues until your child is at least 20 years old. If an older teenager has had rheumatic fever, he or she may continue taking the antibiotics past age 20 to complete a minimum five-year course of preventive treatment.
People who experienced inflammation of the heart when they had rheumatic fever may be advised to take the preventive antibiotic treatment much longer or even for life.
- Anti-inflammatory treatment. Your doctor will prescribe a pain reliever, such as aspirin or naproxen (Anaprox, Naprosyn, others), to reduce inflammation, fever and pain. If symptoms are severe or your child isn't responding to the anti-inflammatory drugs, your doctor may prescribe a corticosteroid, such as prednisone.
- Anticonvulsant medications. If the involuntary movements of Sydenham chorea are severe, your doctor may prescribe an anticonvulsant, such as valproic acid (Depakene, Stavzor) or carbamazepine (Carbatrol, Equetro, others).
Long term care
Discuss with your doctor what type of follow-up and long term care your child will need. Heart damage from rheumatic fever may not show up until many years after the acute illness. Your child should be informed that he or she had rheumatic fever, and when an adult should discuss this with his or her doctor.
- Fort GG. Rheumatic fever. In: Ferri FF. Ferri's Clinical Advisor 2011: Instant Diagnosis and Treatment. Philadelphia, Pa.: Mosby Elsevier; 2011. http://www.mdconsult.com/books/page.do?eid=4-u1.0-B978-0-323-05610-6..00027-5--sc0105&isbn=978-0-323-05610-6&type=bookPage§ionEid=4-u1.0-B978-0-323-05610-6..00027-5--sc0105&uniqId=224600605-3. Accessed Oct. 28, 2010.
- Rheumatic fever. In: Marx JA, et al., eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. St. Louis, Mo.: Mosby; 2009. http://www.mdconsult.com/books/page.do?sid=1075999583&eid=4-u1.0-B978-0-323-05472-0..00081-5--s0050&isbn=978-0-323-05472-0&type=bookPage§ionEid=4-u1.0-B978-0-323-05472-0..00081-5--s0050&uniqId=224600605-4. Accessed Oct. 28, 2010.
- Rheumatic fever. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/sec19/ch281/ch281a.html. Accessed Oct. 28, 2010.
- Choby B. Diagnosis and treatment of streptococcal pharyngitis. American Family Physician. 2009;79:383.
- Gibofsky A, et al. Epidemiology and pathogenesis of acute rheumatic fever. http://www.uptodate.com/home/index.html. Accessed Oct. 28, 2010.
- Gibofsky A, et al. Treatment and prevention of rheumatic fever. http://www.uptodate.com/home/index.html. Accessed Oct. 28, 2010.
- Report for the second meeting of World Health Organization's subcommittee of the Expert Committee of the Selection and Use of Essential Medicines: Antibiotic use for the prevention and treatment of rheumatic fever and rheumatic heart disease in children. Geneva, Switzerland: Royal Hobart Hospital and University of Tasmania. http://www.who.int/selection_medicines/committees/subcommittee/2/RheumaticFever_review.pdf. Accessed Oct. 28, 2010. Hoecker JL (expert opinion). Mayo Clinic, Rochester, Minn. Nov. 3, 2010.
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