chemamr
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| AAzad
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I agree with penadur 1200000 Im . but will you accept to give injection during fever?
is this a real Usmle case?
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AAzad
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| AAzad
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Salicylates remain first-line agents in the treatment of rheumatic fever and usually bring about a dramatic clinical improvement. Therapy should be initiated at 80 to 100 mg/kg/day in children and 4 to 8 g/day in adults to achieve plasma concentrations of 200 to 300 mg/L. After achieving the desired initial steady state concentrations for 2 weeks, the dosage can be reduced to 60 to 70 mg/kg/day for an additional 3 to 6 weeks. Laboratory and clinical rebound may occur 2 to 3 weeks after cessation of anti-inflammatory therapy but usually resolves spontaneously.Streptococci Must be Eradicated
The first step in the treatment of rheumatic fever is eradication of pharyngeal streptococci, thus avoiding chronic, repetitive exposure to streptococcal antigens. The drug of choice is penicillin, which in adequate concentrations for a 10-day period eradicates the organism. Since compliance is often not optimal, a single intramuscular dose of benzathine benzylpenicillin is the most effective form of initial treatment. Antimicrobial therapy, however, does not alter the course, frequency or severity of cardiac involvement
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AAzad
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| AAzad
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So
First step treatment is depo penicillin, first line agent is salicylate.
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