Evaluation of prophylactic penicillin administration in children with joint complaints andhigh serum anti-streptolysin O titers

Objective: Eligibility criteria for the diagnosis of acuterheumatic fever and the reasons for the administration ofprophylactic penicillin were investigated in patients admittedwith complaints of joint and high anti-streptolysin O(ASO) titers.Materials and methods: From the hospital reports, 240patients those ASO titers were higher than 300 Todd unitand aged between 6-16 years were included to the study.The presence of swelling /redness /limitation of movementand number of affected joints, duration of complaints,presence of fever, prophylactic penicillin administration,response to therapy and repetition were asked. Eligibilityfor Jones criteria for the diagnosis of acute rheumaticfever was investigated.Results: Arthritis was present in 39 (16.25%) patientsand 31 (79.5%) of these patients were given penicillinprophylaxis. The number of patients with joint pain was201 (83.75%) and 109 (54.2%) of them were given prophylacticpenicillin administration.Conclusion: In this study, we found high penicillin administrationrate without real indication. Acute rheumaticfever diagnosis in children should be carefully based onJones criteria suggested by WHO and AHA and should beavoided from unnecessary prophylaxis.Key words: joint pain, acute rheumatic fever, penicillin rophylaxis.