Rheumatic fever: treatment principles

Bed chair regime 2-6 wks (in case of carditis & diffuse myocarditis) 1. Antibiotics for strep for 10 days: PenIcillin G 2m U 4-6doses IV: Amoxicillin 2g/day; Cefadroxil 1.0/p (recurrent) if penicillin sensitive: erythromycin 250mg 4/day 2. NSAIDS- until ESR normal to relieve arthralgia & arthritis: Diclofenac 150mg/d 3.Glucocorticoids- until CRP normal. for HF, Recurrent attacks & cardiomegaly: oral prednisolone 1-2mg every 3-5days. Severe- IV pantoprazole 4. Diazepam 2.5mg 3/day for chorea minor 5. Surgical treatment for sever AR & MR (aortic/mitral valve repair or bio-prothesis, LV assist device in HF)