Which medications in the drug class Antibiotics are used in the treatment of Acute Rheumatic Fever?

Updated: Dec 10, 2020
  • Author: Robert J Meador, Jr, MD; Chief Editor: Herbert S Diamond, MD  more...
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Antibiotics are the initial pharmacotherapy for prevention and treatment of rheumatic fever.

Penicillin G procaine (Crysticillin)

Long-acting parenteral penicillin indicated in the treatment of moderately severe infections caused by microorganisms sensitive to penicillin G. IM administration only.

Adults: Deep IM injection into the upper outer quadrant of the buttock only.

Infants and small children: IM injection into midlateral aspect of the thigh is suggested.

Some authors prefer 10 d of therapy.

Penicillin G benzathine (Bicillin L-A)

Interferes with synthesis of cell wall mucopeptides during active multiplication, which results in bactericidal activity. Long-acting depot form of penicillin G. Because of its prolonged blood level, several authors believe this to be the DOC. Others prefer daily injections with short-acting penicillin.

Penicillin VK (Beepen-VK, Betapen-VK, Robicillin VK, Veetids)

Inhibits biosynthesis of cell wall mucopeptide and is effective during stage of active multiplication. Inadequate concentrations may produce only bacteriostatic effects. PO alternative.

Erythromycin (EES, E-Mycin, Ery-Tab, Erythrocin)

Alternative for patients allergic to penicillin (although not the DOC).

Drug may inhibit RNA-dependent protein synthesis by stimulating the dissociation of peptidyl t-RNA from ribosomes. Inhibits bacterial growth.

In children, age, weight, and the severity of infection determine proper dosage. When bid dosing is desired, half-total daily dose may be taken every 12 h. For more severe infections, dose may be doubled.

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