Short-course antibiotic treatment of 4782 culture-proven cases of group A streptococcal tonsillopharyngitis and incidence of poststreptococcal sequelae.
A large-scale study with a 1-year follow-up was performed to compare 10 days of penicillin V with a short-course treatment (5 days) of other oral antibiotics in the treatment of group A beta-hemolytic streptococcus (GABHS) tonsillopharyngitis, to evaluate the efficacy and the incidence of poststreptococcal sequelae. The clinical response rates after completion of therapy were 94.5% in the 5-day group and 93.4% in the penicillin group (P<.001, equivalence test). The GABHS eradication rates were 83.3% in the 5-day group and 84.4% in the penicillin group (P=.022, equivalence test). Poststreptococcal sequelae were rare (5 patients) and did not occur in the context of this study. The efficacy of 5-day antibiotic regimens was equivalent to 10 days of penicillin V, but resolution of clinical symptoms was faster in the 5-day group (P<.001, Fisher's exact test). Recurrent tonsillopharyngitis occurs more frequently after treatment with penicillin (P=.03, Fisher's exact test).
Adam
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Department of Antimicrobial Therapy, Dr. v. Haunersches Children's Hospital, University of Munich, D-80337 Munich, Germany. D.Adam@kk-i. med.uni-muenchen.de.
Scholz
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Helmerking
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D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005921:Glomerulonephritis / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D007223:Infant; D008297:Male; D010612:Pharyngitis / Q000150:complications / Q000188:drug therapy*; D012008:Recurrence; D012213:Rheumatic Fever / Q000209:etiology / Q000517:prevention & control*; D013290:Streptococcal Infections / Q000150:complications / Q000188:drug therapy*; D013297:Streptococcus pyogenes; D013997:Time Factors; D014069:Tonsillitis / Q000150:complications / Q000188:drug therapy*
D000900:Anti-Bacterial Agents