Comparison of cefdinir and penicillin V in the treatment of pediatric streptococcal tonsillopharyngitis.
BACKGROUND
Group A beta-hemolytic streptococcal (GABHS) tonsillopharyngitis continues to be a prevalent pediatric infectious disease that requires prompt treatment for relief of symptoms and to prevent complications.


OBJECTIVE
To compare the efficacy/tolerability of cefdinir and penicillin V in the treatment of pediatric GABHS tonsillopharyngitis as demonstrated in two clinical trials of similar design.


METHODS
Multicenter, randomized, investigator-blinded trials.


METHODS
Children < or =12 years of age with sore throat, pharyngeal erythema and positive rapid streptococcal antigen test results.


METHODS
In Study A patients took cefdinir 7 mg/kg twice daily or 14 mg/kg once daily or penicillin V 10 mg/kg 4 times daily (all regimens for 10 days). In Study B patients took cefdinir 7 mg/kg twice daily for 5 days or penicillin V 10 mg/kg 4 times daily for 10 days.


METHODS
Clinical and microbiologic evaluations were conducted at multiple times during and after therapy.


RESULTS
Of 1274 patients 1122 were evaluable (679 patients received cefdinir; 443 received penicillin V). Clinical cure and microbiologic eradication rates were superior in the combined cefdinir treatment groups (94.9 and 92.7%, respectively), whether given once or twice daily for 10 days or twice daily for 5 days, compared with the penicillin treatment group (88.5 and 70.9%, respectively; P<0.001 for both). Adverse event rates were comparable in the 2 groups.


CONCLUSIONS
Cefdinir is a reliable and well-tolerated drug for the management of GABHS tonsillopharyngitis in children.
Pichichero
M E
ME
Elmwood Pediatric Group and University of Rochester Medical Center, NY, USA.
Gooch
W M
WM
D000077525:Cefdinir; D002511:Cephalosporins / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D010404:Penicillin V / Q000627:therapeutic use*; D010406:Penicillins / Q000627:therapeutic use*; D010612:Pharyngitis / Q000188:drug therapy* / Q000382:microbiology; D013290:Streptococcal Infections / Q000188:drug therapy* / Q000382:microbiology; D013297:Streptococcus pyogenes; D014069:Tonsillitis / Q000188:drug therapy* / Q000382:microbiology; D016896:Treatment Outcome
D002511:Cephalosporins; D010406:Penicillins; D000077525:Cefdinir; D010404:Penicillin V