Balancing the risks of rheumatic heart disease and antimicrobial resistance in South Africa: Insights from a local workshop

Abstract

There is a significant burden of rheumatic heart disease (RHD) in South Africa, where timely diagnosis and treatment of Group A Streptococcus with antibiotics have made significant inroads over the last decade. However, despite the well-established benefits of penicillin for RHD, concerns about antimicrobial resistance have intensified debates around antibiotic stewardship, access and long-term strategies.
Contribution: We outline the findings of a transdisciplinary workshop with key stakeholders in South Africa. A careful balance is needed to achieve the dual goals of protecting vulnerable populations from RHD while upholding responsible and sustainable antibiotic use. Key areas that need to be addressed include the clinical assessment of sore throat, harmonisation of current treatment guidelines in South Africa and policy adaptations.