A follow-up plan should be determined by the patient’s age, strep susceptibility, number of episodes of rheumatic fever, and the presence or absence of valvular disease left behind.
In younger patients, those with a predisposition to susceptibility, recurrent episodes of rheumatic fever, and those with a history of heart inflammation or valve disease, the duration of prophylaxis should be as long as possible, at least 10 years or up to age 40, or even for life.
In patients with a history of heart disease but no residual valve disease, the duration of prevention should be at least 10 years, and in children until adulthood.
For simple arthritis, the duration of prevention can be slightly reduced, to a minimum of 21 years (or for 8 years) for paediatric patients and a minimum of 5 years for adult patients.