The most important treatment of acute rheumatic fever is prevention, associated with improvements in socioeconomic conditions. Once acute rheumatic fever has occurred, treatment includes penicillin to eradicate the streptococcal infection, high dose aspirin as an anti-inflammatory drug, or steroids if the cardiac disease is severe. Heart failure is treated with diuretics, and urgent heart valve replacement may occasionally be required. Long-term antibiotics throughout childhood are essential to prevent recurrences and to reduce the risk of subsequent valvular heart disease. Penicillin is commonly given as a monthly intramuscular injection. Heart surgery may be required at a later stage to.
