title: Tolerance and efficacy of interfering alpha-streptococci in recurrence of streptococcal pharyngotonsillitis: a placebo-controlled study.
abstract: A total of 342 patients with clinical signs of tonsillitis and suspected group A beta-haemolytic streptococci (GAS) aetiology, verified with rapid test and GAS culture, were enrolled in a randomized, placebo-controlled, double-blind, multicentre study. They received antibiotic treatment for 10 days, followed by 10 days of alpha-streptococcal or placebo spray treatment in the ratio of 2 : 1. Pharyngeal status, throat culture and adverse events were investigated up to 75 days after treatment. The frequency of bacteriologically verified clinical recurrence was 13% in the alpha-streptococcal group and 15% in the placebo group at the follow-up on day 22. The corresponding figures at the last valid visit after 45-75 days were 19% and 30%, respectively, a statistically significant difference (p = 0.037). Furthermore, at the last valid visit 5% of subjects in the alpha-streptococcal and 12% in the placebo group were healthy carriers, bacteriological treatment failures, of GAS (p = 0.029). Treatment with alpha-streptococci and placebo spray were equally well tolerated. Thus, re-colonization with alpha-streptococci seem to hinder late recurrences of GAS pharyngotonsillitis.
authors.affiliation: Koppargårdens Health Centre, Orebro, Sweden.
authors.forename: G
authors.initials: G
authors.lastname: Falck
authors.forename: E
authors.initials: E
authors.lastname: Grahn-Håkansson
authors.forename: S E
authors.initials: SE
authors.lastname: Holm
authors.forename: K
authors.initials: K
authors.lastname: Roos
authors.forename: L
authors.initials: L
authors.lastname: Lagergren
mesh_terms: D000293:Adolescent; D000328:Adult; D000336:Aerosols; D000368:Aged; D000898:Antibiosis; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D006801:Humans; D008875:Middle Aged; D010612:Pharyngitis / Q000382:microbiology / Q000517:prevention & control*; D010614:Pharynx / Q000382:microbiology; D012008:Recurrence; D013290:Streptococcal Infections / Q000382:microbiology / Q000517:prevention & control*; D013291:Streptococcus; D013297:Streptococcus pyogenes; D014069:Tonsillitis / Q000382:microbiology / Q000517:prevention & control*
chemical_list: D000336:Aerosols