Guidelines on rheumatic fever, rheumatic heart disease & GAS sore throat
Download clinical guidelines, tools and other information related to group A streptococcal (GAS) sore throat, rheumatic fever, and rheumatic heart disease.
The Heart Foundation has supported the development of three evidence-based, best practice New Zealand guidelines to maximise diagnosis and management of rheumatic fever, rheumatic heart disease and group A streptococcal sore throat.
- Diagnosis, Management and Secondary Prevention of Acute Rheumatic Fever and Rheumatic Heart Disease: (2014 Update second edition) (PDF).
- Group A Streptococcal (GAS) Sore Throat Management Guideline: 2019 Update (PDF).
- Proposed Rheumatic Fever Primary Prevention Programme 2009 (PDF).
Diagnosis, Management and Secondary Prevention of Acute Rheumatic Fever and Rheumatic Heart Disease: (2014 Update second edition)
This guideline for the diagnosis, management and secondary prevention of acute rheumatic fever (ARF) and rheumatic heart disease (RHD) was published in 2014. As a result of the 2019 update to the Group A Streptococcal Sore Throat Management Guideline, the following medication regimes have changed, but have not been updated in this document.
|Page reference||Medication||2014 ARF and RHD Guideline||Medication regime change in 2019 GAS Guideline Update|
|13||Phenoxymethylpenicillin||Twice daily||2-3 times daily|
|13, 29||Amoxicillin||Once daily||1-2 times daily|
|26, 29, 36, 70||Erythromycin max daily dose||1000mg||1600mg|
Group A Streptococcal (GAS) Sore Throat Management Guideline 2019 Update.
The Group A Streptococcal Sore Throat Management guideline was substantially reviewed and updated in 2019. Key changes from the 2014 edition include:
- a redefinition of ‘high risk for rheumatic fever’
- revisions of Clinical Question 7 on the management of treatment failure and GAS recurrence, including the removal of cephalexin from antibiotic prescribing
- erythromycin regime change
- revision of household contact management.
Download the Summary of key changes for 2019 GAS guideline update 2019 (PDF).
Download Guide for Sore Throat Management - Algorithm (PDF).
Download Guide for Household Sore Throat Management - Algorithm (PDF).
Proposed Rheumatic Fever Primary Prevention Programme 2009 – also known as the Primary Prevention of Rheumatic Fever guideline
The following Proposed Rheumatic Fever Primary Prevention Programme was published in 2009. As a result of the 2019 update to the Group A Streptococcal Sore Throat Management Guideline, the definition of high risk for rheumatic fever has been updated but is not updated in this document.
Guidelines for rheumatic fever: Proposed rheumatic fever primary prevention plan (2009)
Group A Streptococcal Sore Throat Management Guideline: Update 2019
Populations at high risk of rheumatic fever:
|The population at High Risk for Rheumatic Fever is defined as those individuals who have a personal, family or household history of rheumatic fever, or who have two or more of the following criteria:|
The Heart Foundation: Primary Care eLearning features a free rheumatic fever and rheumatic heart disease course. Visit our eLearning platform.
Related clinical resources
The Heart Foundation has a number of other RF-related clinical tools which can be downloaded below.
Resources for patients
The Heart Foundation has produced a booklet for families affected by rheumatic fever. It explains what rheumatic heart disease is and what to expect from the journey ahead.
Our Journeys programme offers people the opportunity to hear from others living with heart disease or to share their own story.Hear from people living with RHD