Secondary prevention
Once a person has been diagnosed with ARF, the objective is to prevent further GAS pharyngitis infections. For this reason, the use of prophylactic penicillin (via intramuscular injection, administered every 28 days) is recommended. Use of prophylactic penicillin is associated with an 87-96
Per cent reduction in ARF recurrence, a 71-91 per cent reduction in GAS pharyngitis and may also reduce severity and mortality of RHD.
Prophylaxis should continue for 10 years, or up to the age of 21 (which ever is the longer period), but for those with evidence of carditis, it should continue to age 30 or possibly for life.