Q: My 15 years old brother had rheumatic valve surgery. The doctor has advised Penidure every month, but it is not available these days in any medical stores. Could you please advise any other substitute of Penidure?

A:Injection Penidure is the first choice drug for prevention of further attacks of rheumatic fever. A substitute is recommended only in cases of allergy to Penicillin. In your brother’s case, if you have totally exhausted all potential sources of this drug, you may consider some other orally administered antibiotic. In this regard, you would be better guided by your treating physician/cardiologist.