What is the drug that can be used for rheumatic fever prophylaxis in a patient with a history of allergy to Penicillin?
High-Yield Explanation
The best antibiotic for secondary prophylaxis is benzathine penicillin G (1.2 million units,or600,000units if <=27kg) delivered every 4weeks. It can be given every 3weeks, or even every 2weeks, to persons at, paicularly high risk. Oral penicillin V (250mg) can be given twice daily instead but is less effective than benzathine penicillin G. Penicillin allergic patients can receive erythromycin (250mg) twice daily.Reference: Harrison&;s Principles of Internal Medicine; 19th edition; Chapter 381; Acute Rheumatic Fever