HUNG-CHI LUEMEI-HWAN WUJOU-KOU WANGWu F.-F.Wu Y.-N.2021-01-052021-01-0519940022-3476https://www.scopus.com/inward/record.uri?eid=2-s2.0-0027994815&doi=10.1016%2fS0022-3476%2806%2980188-5&partnerID=40&md5=ab11f443719b53362bd8f520ec1df931https://scholars.lib.ntu.edu.tw/handle/123456789/538556Objective: To compare the efficacy of injections of 1.2 million units of benzathine penicillin G given every 3 weeks versus every 4 weeks for secondary prevention of rheumatic fever, based on the long-term outcome of patients receiving such prophylaxis. Methods: A total of 249 consecutive patients with rheumatic fever, randomly assigned to either a 3-week or a 4-week regimen, were examined every 3 to 6 months, and followed for 794 and 775 patient-years, respectively. Results: Compliance with each regimen was comparable: 83 (66.9%) of 124 patients in the 3-week group versus 92 (73.6%) of 125 patients in the 4-week group stayed in the program (p>0.05). Streptococcal infections occurred less frequently in those receiving the 3-week regimen: 7.5 versus 12.6 per 100 patient-years (p<0.01). Prophylaxis failed in 2 patients receiving the 3-week regimen and in 10 receiving the 4-week regimen (0.25 and 1.29 per 100 patient-years respectively; p=0.015). Serum penicillin levels were adequate (?0.02 μg/ml) in 100 (56%) of 179 samples obtained 21 days after penicillin injection in the 3-week regimen, and in 51 (33%) of 155 samples obtained 28 days after injection in the 4-week regimen (p<0.01). Of 71 patients with mitral regurgitation in the 3-week regimen, 47 (66%) no longer had the murmur; of 87 patients in the 4-week regimen, 40 (46%) no longer had the murmur (p<0.05). Conclusions: This 12-year controlled study indicates that the outcome of patients with rheumatic fever is better with a 3-week than with a 4-week penicillin prophylaxis regimen. Greater emphasis and more widespread use of the 3-week regimen should be recommended. ? 1994 Mosby-Year Book, Inc.[SDGs]SDG3benzathine penicillin; adolescent; adult; article; child; clinical trial; controlled clinical trial; controlled study; drug efficacy; female; human; major clinical study; male; priority journal; randomized controlled trial; rheumatic fever; Adolescent; Adult; Aortic Valve Insufficiency; Child; Child, Preschool; Drug Administration Schedule; Female; Follow-Up Studies; Heart Murmurs; Humans; Male; Mitral Valve Insufficiency; Patient Compliance; Penicillin G, Benzathine; Prospective Studies; Recurrence; Remission Induction; Rheumatic Fever; Rheumatic Heart Disease; Time Factors; Treatment Outcomejournal article10.1016/S0022-3476(06)80188-579654392-s2.0-0027994815