Acetylsalicylic acid (O) 100 mg/kg/24 hrs in 4-6 divided doses for both adults and children); dose to be reduced if tinnitus or other toxic symptoms ate observed.
NOTE: Acetylsalicylic acid should be continued until fever, all signs of joint inflammation and the ESR have returned to normal, then reduce gradually over two weeks. If symptoms recur, full doses should be restarted |
In severe carditis with development of increasing heart failure or failure of response to acetylsalicylic acid, give:
Prednisolone (O) 1.5 mg/kg/24 hrs.
Gradual reduction and discontinuation of Prednisolone may be started after at least 3-4 weeks when there has been a substantial reduction in clinical disease activity; Acetylsalicylic acid should be continued as above.
NOTE Heart failure should be managed in the usual way. All patients with carditis must be kept on strict bed rest until all evidence of active carditis has resolved and the ESR has returned to normal. Activity should then be gradually increased. |
