New method for treating rheumatic fever pioneered

University of Otago (Wellington) public health researcher Dr Julie Bennett. Photo: supplied
University of Otago (Wellington) public health researcher Dr Julie Bennett. Photo: supplied
Aside from vegetables, one of the things children hate most is injections.

Unfortunately for patients with acute rheumatic fever - most of whom are children or teenagers - a painful intramuscular injection of benzathine penicillin was needed every month to keep the disease at bay.

The treatment had not changed for the past 70 years, and because it was so painful, many patients avoided it.

However, a University of Otago-led study came up with a significantly less painful rheumatic heart disease prevention delivery system, which was proving very popular with patients.

Lead author and University of Otago (Wellington) public health researcher Dr Julie Bennett said in rare cases people suffering from a group A streptococcus infection, such as strep throat, could go on to develop acute rheumatic fever or rheumatic heart disease, which caused almost 400,000 deaths worldwide each year.

"To prevent heart failure and death, patients with rheumatic fever need to have very painful deep penicillin injections into their backsides every month for a minimum of 10 years.

"The penicillin is to prevent the patient having any more strep A infections.

"Which can lead to greater heart damage.

"Acute rheumatic fever and rheumatic heart disease have all but disappeared from high-income countries, yet in Aotearoa New Zealand, they remain an alarming and inequitable cause of preventable suffering and death for Māori and Pacific peoples."

Dr Bennett said the study trialled a new way of delivering long-acting penicillin, using a small needle inserted into patients’ stomachs.

"Patients said this method was less painful than their usual injection.

"This method also enabled a larger dose of penicillin to be administered, which meant only needing to have an injection every three months."

She said the new method had now been trialled on more than 50 patients in the North Island, and more than 95% of the study participants said they wanted to remain on the new method of treatment.

"This method shows enormous promise as an alternative mode of penicillin delivery, and may increase adherence through improved patient experience.

"Greater adherence may prevent disease progression and death here in New Zealand and globally."

She said the phase 2 clinical trial had to go through Medsafe approvals and treatment guidelines, before the new treatment method could be adopted.