Recolonization with selected alpha-streptococci for prophylaxis of recurrent streptococcal pharyngotonsillitis--a randomized placebo-controlled multicentre study.
In a randomized, placebo-controlled, double-blind, multicentre study, 130 patients with recurrence of group A beta-hemolytic streptococci (GAS) and clinical signs of pharyngotonsillitis were enrolled. The patients received antibiotic treatment for 10 days, followed by 10 days of alpha-streptococci-inhibitory to GAS-or placebo spray treatment. Patients taking antibiotic treatment for at least 9 days and using the spray for at least 5 days were included in the efficacy analysis. In addition, recurrence within the first 5 days of spray treatment was classified as 'early treatment failure'. The clinical recurrences (bacteriologically verified) in the alpha- (n = 51) and placebo-treated (n = 61) patient groups were 2% (n = 1) and 23% (n = 14) respectively, in patients given spray for at least 5 days (p = 0.004). The inclusion of 'early treatment failures' reduces this difference (p = 0.064). Both treatments were equally well tolerated. Thus, alpha-streptococci given as a spray and used for at least 5 days significantly prevented recurrence of GAS pharyngotonsillitis.
Roos
K
K
ENT Department, Lundby Hospital Göteborg, Sweden.
Holm
S E
SE
Grahn-Håkansson
E
E
Lagergren
L
L
D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D004311:Double-Blind Method; D004917:Erythromycin / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008828:Microbiological Techniques; D008875:Middle Aged; D009330:Nebulizers and Vaporizers; D010404:Penicillin V / Q000627:therapeutic use*; D010406:Penicillins / Q000627:therapeutic use; D010612:Pharyngitis / Q000382:microbiology / Q000517:prevention & control*; D010614:Pharynx / Q000382:microbiology*; D012008:Recurrence; D013290:Streptococcal Infections / Q000382:microbiology / Q000517:prevention & control*; D013297:Streptococcus pyogenes / Q000302:isolation & purification*; D013298:Streptococcus sanguis / Q000502:physiology*; D014069:Tonsillitis / Q000382:microbiology / Q000517:prevention & control*
D000900:Anti-Bacterial Agents; D010406:Penicillins; D004917:Erythromycin; D010404:Penicillin V