*Dr. Anil Batta and Umesh Kumar


Rheumatic fever is still posing challenge for the third world countries. Exception to this somehow remains in New Zealand. Rheumatic fever is still a cause of cardiac disease which has to be challenge seriously. This is becoming a headache for heavy financial burden in poor countries. So, in suspected patients’ streptococcal infection is detected from the tonsils, staphylococcus aureus can be detected by taking swab from the nose, it can be diagnosed by taking blood sample for vitamin D, ferritin and hair of the head. The main diagnostic web is clinical and ECG on the other hand sever case require medical and surgical intervention. In this context we are focusing on the diagnosis and heart valve lesions the standard treatment of these patient is single short of benzathine penicillin given intramuscular and dose is 1.2 million units AST. After three weeks again they above dose is repeated. all the other drugs except azithromycin have a long half-life and other good points which make it as alternative to penicillin for these patients. Though penicillin has been used decade together but know azithromycin is posing as an effective contender. so, this drug should be used as an alternative to penicillin because for a long-time azithromycin has proved itself as an effective at relatively affordable price. In our study, oral azithromycin (AZT) 500 mg once weekly was compared to oral penicillin (phenoxy methyl penicillin 250 mg twice daily). Fifty-two consecutive patients with established RHD (54 percent males, mean age 21 years) were randomly assigned to one of two groups: AZT or oral penicillin. Patients were evaluated clinically, serologically, and by throat swab culture taken at randomization, 1 month, 3 months, and 6 months. The absence of streptococcal colonization, infection, or fever at the end of 6 months was the end point. During the study, four patients (15.4 percent) in the AZT group developed sore throat and fever, as well as a positive throat culture and serology indicating streptococcal infection. None of the group of patients spelled positive while taking azithromycin. In the oral penicillin group again, none showed sterilization from streptococcal infection. So, there was no demarcation as far as superiority is considered.

Keywords: rheumatic heart disease rheumatic fever, penicillin, developing countries, disease outbreaks, scarlet fever, streptococcus morbidity, mortality, upper respiratory infections.

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