Pharyngitis/tonsillitis: European and United States experience with cefpodoxime proxetil.
Most authorities continue to recommend penicillin as the treatment of choice for group A streptococcal pharyngitis. If penicillin is used, 10 days of treatment are necessary to achieve a clinical and bacteriologic cure. The usually recommended penicillin V dose is 250 mg (400,000 IU) three times daily. Twice daily dosing is acceptable to some authorities if compliance is good. However, oral penicillin fails to eradicate group A streptococci from the pharynx in up to 17% of cases; in some studies 30% failure rates have been reported. Several European and United States studies indicate that a variety of oral cephalosporins, when used for 10 days, are significantly superior to penicillin V in eradicating group A streptococci from the pharynx. For example cefpodoxime proxetil given twice daily for 10 days is comparable to penicillin V given three times daily for 10 days in achieving a clinical cure and appears to be significantly superior to penicillin in eradicating group A streptococci from the pharynx. Preliminary studies from Europe and the United States strongly suggest that 5-day therapy with cefpodoxime (or other selected oral cephalosporins) is at least as effective, clinically and microbiologically, as 10-day therapy with penicillin V. Further clinical trials are warranted to confirm the adequacy of 5-day treatment and to assess the efficacy of cefpodoxime and other agents in preventing rheumatic fever.
Dajani
A S
AS
Department of Pediatrics, Wayne State University School of Medicine, Detroit, MI, USA.
D000284:Administration, Oral; D000328:Adult; D000658:Amoxicillin / Q000008:administration & dosage; D015296:Ceftizoxime / Q000008:administration & dosage / Q000031:analogs & derivatives*; D002511:Cephalosporins / Q000008:administration & dosage; D002648:Child; D002986:Clinical Trials as Topic; D004334:Drug Administration Schedule; D005060:Europe; D006801:Humans; D010406:Penicillins / Q000008:administration & dosage; D010612:Pharyngitis / Q000188:drug therapy*; D013290:Streptococcal Infections / Q000188:drug therapy*; D014069:Tonsillitis / Q000188:drug therapy*; D017211:Treatment Failure; D014481:United States; D000097627:Cefpodoxime Proxetil
D000658:Amoxicillin; D015296:Ceftizoxime; D002511:Cephalosporins; D010406:Penicillins; D000097627:Cefpodoxime Proxetil