A follow-up study of 311 patients who acquired rheumatic fever in Nashville, Tenn, during the period from 1963 to 1969 showed that 53% took penicillin prophylaxis regularly, 36% did not take it as recommended, and 11% did not take it at all. There were no recurrences among those who received prophylaxis by injection regularly, six recurrences among those who took oral prophylaxis regularly, and no recurrences among 45 subjects who did not take prophylaxis. Among these 45, however, were 29 for whom prophylaxis was not recommended by their physicians. The original study indicated that the incidence of acute rheumatic fever among blacks was twice as high as among whites. In the present study, incidence of rheumatic heart disease and recurrences was substantially higher among blacks than among whites.
(JAMA 238:1512-1515, 1977)
Quinn RW, Federspiel CF, Lefkowitz LB, Christie AU. Recurrences and Sequelae of Rheumatic Fever in Nashville: A Follow-up Study. JAMA. 1977;238(14):1512–1515. doi:10.1001/jama.1977.03280150082034
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