A 7-year-old child who had rheumatic carditis 2 years ago is currently asymptomatic with mild mitral regurgitation on echocardiography. Which is the correct prophylaxis regimen to prevent recurrence of rheumatic fever?
- A Benzathine penicillin G 600,000 units IM every 3 weeks
- B Benzathine penicillin G 1.2 million units IM every 4 weeks ✓
- C Oral phenoxymethylpenicillin 250 mg twice daily
- D Oral amoxicillin 500 mg daily
Correct answer: B. Benzathine penicillin G 1.2 million units IM every 4 weeks
Explanation
Secondary prophylaxis for rheumatic fever with carditis (including mild MR) requires benzathine penicillin G 1.2 million units IM every 4 weeks (or every 3 weeks in high-risk endemic areas). This child with carditis should receive prophylaxis for at least 10 years from last attack or until age 25 years (whichever is longer); if persistent carditis, some guidelines recommend lifelong prophylaxis. Oral phenoxymethylpenicillin 250 mg twice daily is an alternative but has lower compliance and efficacy than IM regimen.
Reference: Ghai Essential Pediatrics, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.