Trends in rheumatic fever: clinical aspects and perspectives in prophylactic treatments

• Published in: Expert opinion on drug delivery Vol. 9; no. 9; p. 1099
• Main Authors: De Holanda E Silva, Kattya Gyselle, Barratt, Gillian, De Oliveira, Anselmo Gomes, Do Egito, Eryvaldo Socrates Tabosa
• Format: Journal Article
• Language: English
• Published: England 01.09.2012
• Subjects: Acute Disease; Animals; Anti-Bacterial Agents - therapeutic use; Antibiotic Prophylaxis; Drug Administration Schedule; Drug Delivery Systems; Humans; Penicillin G Benzathine - therapeutic use; Rheumatic Fever - diagnosis; Rheumatic Fever - microbiology; Rheumatic Fever - prevention & control; Streptococcal Infections - diagnosis; Streptococcal Infections - microbiology; Streptococcal Infections - prevention & control; Streptococcus pyogenes - drug effects
• ISSN: 1744-7593
• DOI: 10.1517/17425247.2012.702104

Rheumatic fever (RF), a systemic illness that may occur following Group A beta-hemolytic streptococcal (GABHS) pharyngitis in children, is a major problem in countries with limited resources. Because of its long track record and low cost, an injection of benzathine penicillin G (BPG) suspension every 3 or 4 weeks has been used as secondary prophylaxis. Despite its excellent in vitro efficacy, the inability of BPG to eradicate GABHS has been frequently reported. This work reviews the possible causes of failure, as well as the inconvenience of the current prophylactic treatment of acute RF and suggests a new pharmacotherapeutic system that could replace the current one. RF is a major problem concerning only countries with limited resources and could be considered as a neglected disease. The dose regimen using BPG suspension results in failures, which could be avoided by the use of nanocarrier-based systems. To meet this ultimate goal, the research should be transposed from the laboratory scale to an industrial and clinical application level. This research should be conducted to produce a pharmaceutical dosage form that will be commercially available, consumed by and affordable for patients. However, health, environmental and socioeconomic hazards should be considered.