Correct! To more quickly reduce the load on Sally's heart most physicians will start Sally off with prednisone (2 mg/kg/day; divided over 4 doses in a day for 3 weeks.). Then add aspirin to the treatment when withdrawing the steroid and for up to 6 weeks after removal of the steroid. Notice I said most physicians. There is still some debate over the use of steroids.
If no carditis is present usually only aspirin (one grain per pound (90 to 120 mg/kg/day; divided into 4 doses)) is used. Remember, this is not a cure. The inflammation is being suppressed and there is no evidence to support these treatments will shorten the inflammatory response.
The last question! Patients that have had one episode of rheumatic fever are much more likely to develop rheumatic fever after an infection with S. pyogenes. What other treatment would you suggest to prevent another rheumatic fever episode?