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Structured summary

Treatment of sore throat (pharyngitis) to prevent rheumatic heart disease – a rapid summary

Published Updated

Among people with sore throat (pharyngitis), penicillin treatment probably reduces rheumatic fever recurrences and streptococcal throat infections (moderate certainty of evidence). No studies reported the effects of penicillin treatment on rheumatic heart disease progression, disability, mortality or adverse events among people with sore throat.

Among people with sore throat (pharyngitis), penicillin treatment probably reduces rheumatic fever recurrences and streptococcal throat infections (moderate certainty of evidence). No studies reported the effects of penicillin treatment on rheumatic heart disease progression, disability, mortality or adverse events among people with sore throat.


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    Plain language summary

    Among people with sore throat (pharyngitis), penicillin treatment probably reduces rheumatic fever recurrences and streptococcal throat infections (moderate certainty of evidence).

    No studies reported the effects of penicillin treatment on rheumatic heart disease progression, disability, mortality or adverse events among people with sore throat (pharyngitis).

    Background

    Acute pharyngitis is hallmarked by acute onset of sore throat; the absence of cough, nasal congestion and discharge suggests a bacterial aetiology. Rapid antigen detection tests allow immediate point-of-care assessment of group A Streptococcus (GAS) pharyngitis. The goal of treatment of GAS is to prevent acute rheumatic fever, reduce the severity and duration of symptoms, and prevent transmission. Acute pharyngitis is generally a self-limited condition with resolution within two weeks. Infected individuals are not, however, immune to reinfection with most aetiological pathogens (BMJ Best Practice (accessed Dec 18 2020)).

    Acute rheumatic fever is an autoimmune disease that may occur following group A streptococcal throat infection. It can affect multiple systems, including the joints, heart, brain, and skin. Only the effects on the heart can lead to permanent illness; chronic changes to the heart valves are referred to as chronic rheumatic heart disease. No treatment has been shown to alter the progression of acute rheumatic fever to chronic rheumatic heart disease. Secondary prophylaxis can improve the prognosis of established rheumatic valvular disease. The recommended choice of treatment is long-term penicillin secondary prophylaxis (BMJ Best Practice (accessed Nov 20 2020))

    08.02.21: A few changes made in the background and method description part of the rapid summary to make it more accessible.

    This rapid review was commissioned by the Bergen Centre for Ethics and Priority Setting (BCEPS), University of Bergen.

    About this publication

    • Year: 2021
    • By: Norwegian Institute of Public Health (NIPH)
    • Authors Fønhus MS, Dalsbø TK.