title: Failure of secondary prophylaxis with erythromycin in rheumatic heart disease.
abstract: BACKGROUND
  Erythromycin is recommended for secondary prophylaxis in children with rheumatic heart disease, who are allergic to penicillin.
  
  
  METHODS
  A 9-year-old girl, with rheumatic heart disease, on secondary prophylaxis with erythromycin 250 mg BD, presented with acute rheumatic fever.
  
  
  RESULTS
  Responded to steroids and started on a higher dose (250 mg TDS) of erythromycin for secondary prophylaxis.
  
  
  CONCLUSIONS
  There is need to document the resistance of group A streptococci to erythromycin.
authors.affiliation: Division of Pediatric Cardiology, Department of Pediatrics, PGIMER and Associated Dr RML Hospital, New Delhi, India. Correspondence to: Dr Dinesh Kumar Yadav, Abhay Khand- I, H No. 169, Indirapuram Ghaziabad, UP, India. dineshkumar169@yahoo.co.in.
authors.forename: Dinesh Kumar
authors.initials: DK
authors.lastname: Yadav
authors.forename: Puneet
authors.initials: P
authors.lastname: Anand
authors.forename: Eden
authors.initials: E
authors.lastname: Bhutia
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D002648:Child; D004917:Erythromycin / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D011239:Prednisolone / Q000627:therapeutic use*; D012214:Rheumatic Heart Disease / Q000188:drug therapy*; D017211:Treatment Failure
chemical_list: D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D004917:Erythromycin; D011239:Prednisolone