Efficacy of using Azithromicine in secondary prophylaxis of pencillin sensitive documented Rheumatic Heart Disease patients.

Background: Rheumatic heart disease (RHD) remains a significant health concern in developing countries, particularly affecting young adults. Long-term secondary prophylaxis is crucial in preventing recurrent streptococcal infections. Objectives: To evaluate the clinical profile and echocardiographic features of patients with echocardiographically proven rheumatic valvular heart disease who were allergic to penicillin and receiving oral azithromycin as prophylactic therapy over a 6-month period. Patients and Methods: This cross-sectional study included 50 patients aged 18–45 years with confirmed rheumatic valvular heart disease, attending the Cardiology Department at Minia University Hospital, allergic to penicillin and received oral AZT (500 mg daily for 6 days, then weekly for 6 months). Diagnosis was based on the 2023 World Heart Federation (WHF) echocardiographic criteria for RHD. Clinical history, physical examination, laboratory investigations, and echocardiographic data were collected and analyzed. Results: The mean age of the studied population was 25.82 ± 3.62 years, with a mean BMI of 28.08 ± 2.15 kg/m². No comorbidities such as diabetes, hypertension, or autoimmune diseases were reported. Most patients (92%) had mild mitral and tricuspid regurgitation.Echocardiographic findings showed a mean ejection fraction of 67.6 ± 3.04%,mean left atrial diameter of 3.51±0.43 cm, and mean pulmonary artery systolic pressure of 23.51 ± 2.96 mmHg.Laboratory results were within normal ranges; all patients had negative ESR, and 86% had negative CRP.The mean ASO titre was 98.26 ± 25.01 IU/mL. Conclusion:Azithromycin is a well-tolerated alternative prophylactic therapy for penicillin-allergic patients with rheumatic heart disease, showing stable clinical, echocardiographic, and laboratory parameters over a 6-month follow-up period.