Table 1.

Recommended Secondary Prophylaxis Duration, as per RHD Priority Category

Priority Category	Priority Category Definition	Duration of Secondary Prophylaxis
All patients		Minimum 10 y since last episode of ARFa
1	Severe RHD, previous valve repairs or prosthetic valves, or symptomatic moderate RHD	Until age 40 y (or longerb)
2	Moderate RHD (asymptomatic) with normal left ventricular function	Until age 35 y
3	Mild RHD or no RHD but on secondary prophylaxis after an episode of ARF	Until age 21 y or at least 10 y after last ARF, whichever is longer

Table adapted from Australian ARF/RHD guidelines, 2nd ed. [10].

Abbreviations: ARF, acute rheumatic fever; RHD, rheumatic heart disease.

^aWhere a diagnosis of RHD is made without knowledge of previous ARF, guidelines recommend continuation until age 35 years for patients who are older than age 25 years at the time of RHD diagnosis.

^bPriority 1 patients may be continued on secondary prophylaxis after age 40 years if a specialist deems that this is appropriate (eg, severe disease and risk of further ARF is considered to be high).