New rheumatic fever guidelines

New guidance has been published on the prevention of rheumatic fever. There are many changes in this comprehensive document from previous guidelines, with much more emphasis on equity, and social determinants of health and their impact, and how those risks can be mitigated. 

There are changes to the guidance on the identification and management of strep A infections, notably:  

• rapid molecular tests are recommended to support timely diagnosis of Strep A sore throat in high-incidence ARF populations as part of community ‘test and treat’ services. 

In antibiotic treatment of Strep A sore throat: 

• phenoxymethylpenicillin dosing has been simplified to twice daily dosing 
• recommendations have been added for the administration of intramuscular (IM) benzathine penicillin
• roxithromycin is no longer recommended for people with documented penicillin allergy, while erythromycin remains available for this indication.  

Changes to the Community HealthPathways will follow this long awaited publication - in the meantime some key algorithms for GP care are found on pages 93-95. 

Read more on our new rheumatic fever resources page.