To base the diagnosis of RHD on these two tests alone is not justifiable as there are strict criteria for labelling any case as rheumatic fever
(The Revised Jones' Criteria, American Heart Association - see http://www.medicalcriteria.com/criteria/car_jones.htm)
Thus, I do NOT agree with the use of antibiotics in this fashion at all on the basis of a raised ESR
and ASOT. In fact, a simple sore throat
caused by the streptococcus
may produce both these findings without there being ANY EVIDENCE of rheumatic fever. On the other hand, prophylactic use of antibiotics to PREVENT strep infections is not based on any firm evidence, so again, it's a NO from my side.
- Dr. Taher