Beaton A, Okello E, Rwebembera J, et al. - In this study, secondary antibiotic prophylaxis administered to children and adolescents 5 to 17 years of age with latent rheumatic heart disease was shown to cause a reduction in the risk of disease progression at 2 years.

• In this randomized, controlled trial, Ugandan children and adolescents 5 to 17 years of age with latent rheumatic heart disease were randomized to receive either injections of penicillin G benzathine (also known as benzathine benzylpenicillin) every 4 weeks for 2 years or no prophylaxis.

• A total of 818 participants were involved in the modified intention-to-treat analysis, and 799 (97.7%) completed the trial.

• In the prophylaxis group vs control group, echocardiographic progression at 2 years was found in 0.8% vs 8.2% of the participants, respectively, (risk difference, −7.5 percentage points; 95% confidence interval, −10.2 to −4.7; P<0.001).

• In the prophylaxis group, serious adverse events due to prophylaxis occurred in two participants, including one episode of a mild anaphylactic reaction (representing <0.1% of all given doses of prophylaxis).