Akut Romatizmal Ateşe Bağlı Kardit Gelişen Hastalarda Penisilin Profilaksisinin Etkinliğinin Değerlendirilmesi

Objective: To show the effectiveness of primary and secondary penicillin prophylaxis for acute rheumatic fever patients. Material and Methods: Patients diagnosed with acute rheumatic fever and followed-up at the pediatric cardiology department between November 1997 and August 2012 were studied retrospectively regarding their demographic and clinical characteristics. Results: We included 71 patients (53.5% female and 46.5% male) diagnosed with Acute Rheumatic Fever (ARF) in this study. The mean age of the patients was 10.8±3.0 years. Carditis was the most frequent clinical finding and was seen in 90%. The mitral valve was affected in 96% of the carditis patients. The most frequent valvular involvement was combined mitral regurgitation (MR) and aortic regurgitation (AR), seen in 33 (51.6%) of the patients. Primary and secondary penicillin prophylaxis were provided to all patients. The patients with carditis were followed up for a mean duration of 3.4±2.7 years after the diagnosis. The degree of MR was decreased in 20 (32.2%) cases and the MR completely recovered in 7 (11.3%) cases among the 62 patients with MR. The degree of AR decreased in 7 (20%) cases and the AR recovered completely in 10 (28.6%%) cases among the 35 AR patients. Conclusion: The important morbidity caused by ARF can be prevented with the primary penicillin prophylaxis in the acute phase and secondary penicillin prophylaxis afterwards.