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Acute rheumatic fever (ARF) is an abnormal immune reaction following Streptococcus pyogenes (Strep A) infection of the throat, and likely the skin. Primary prevention is the prompt and appropriate antibiotic treatment of StrepA infection, and it can reduce the risk of developing ARF and subsequent rheumatic heart disease. This article explores current recommendations for primary prevention of ARF in Australia. People at increased risk of ARF should beoffered empirical antibiotic treatment of Strep A infections to reduce this risk. People a