Penicillin seen to cut heart risk
Penicillin appears to significantly reduce rheumatic heart disease progression in children.
An international study has found a regular antibiotic treatment cut the rate of progress to serious rheumatic heart disease in children by up to 90 per cent.
Rheumatic heart disease is caused by damage to the valves of the heart, following a case of Strep throat.
It is considered a disease of poverty and disadvantage, and Australia has some of the highest rates in the world.
The disease disproportionately affects Indigenous Australians, with about 3-5 per cent of those living in remote and rural areas having the condition, and children aged between five and 14 years most likely to get rheumatic fever.
Until this recent study, it was unknown if antibiotics were effective at preventing the progression of latent rheumatic heart disease.
The study involved 818 Ugandan children aged 5-17 years with latent rheumatic heart disease.
The participants either received four-weekly injections of penicillin for two years, or no treatment.
All underwent echocardiography screening, where ultrasound waves produce images of the heart, at the start and end of the trial.
The findings show just three (0.8 per cent) participants who received penicillin experienced latent rheumatic heart disease progression, compared to 33 (8.3 per cent) who did not receive the treatment.
Professor Andrew Steer from the Murdoch Children's Research Institute (MCRI) says screening for latent rheumatic heart disease is critical to stop progression, because heart valve damage is largely untreatable.
“Children with latent rheumatic heart disease have no symptoms and we cannot detect the mild heart valve changes clinically,” he said.
“Currently, most patients are diagnosed when the disease is advanced, and complications have already developed. This late diagnosis is associated with a high death rate at a young age, in part due to the missed opportunity to benefit from preventative antibiotic treatment. If patients can be identified early, there is an opportunity for intervention and improved health outcomes.”
The study shows a cheap and easily available penicillin can prevent progression of latent rheumatic heart disease into more severe, irreversible valve damage.