There were 300 admissions to the Cook Hospital with rheumatic fever in 1958-83. During 1958-73 oral penicillin was used for secondary prophylaxis and 77 (35%) of 223 admissions were recurrences. From 1974-83 when parenteral benzathine penicillin was increasingly used there were 77 admissions of which 14 (18%) were readmissions. An effective programme of secondary prophylaxis using benzathine penicillin and co-ordination of hospital and community health services is outlined. One hundred and eight patients with a first attack of rheumatic fever were seen in 1968-82. The chance of a recurrence in patients in whom oral prophylaxis was instituted was 15% two years after the initial attack and 35% after six years. Institution of parenteral prophylaxis significantly reduced the risk of recurrence (p = 0.0009) which was 2% six years after the first attack.
Administration, Oral Child