title: Failure to eradicate Group A beta-haemolytic streptococci (GABHS) from the upper respiratory tract after antibiotic treatment.
abstract: The clinical efficacy, safety and bacteriological eradication of Group A beta-haemolytic streptococci (GABHS) from the throat was studied after treatment of streptococcal tonsillopharyngitis with three commonly used oral antibiotics in a prospective, open labelled, comparative, randomised trial of 265 evaluable patients seen in one centre. All three antibiotics were administered in the recommended doses; penicillin V q8 hourly and clarithromycin q12 hourly were given for 10 days and cefprozil q12 hourly for 5 days. Clinical results and adverse events were similar for all three antibiotics used, with a prompt clinical outcome of >95%. Cefprozil had the best bacteriological eradication rate (failed to eradicate: 13.2, 15.1, 2.3; relapses: 13.2, 11.4, 5.7%, for penicillin, clarithromycin and cefprozil, respectively). Oral penicillin remains a clinically effective and safe antibiotic for the treatment of streptococcal pharyngitis. However, compliance and convenience for parents and children when they are asked to follow a 10 days course, especially when the patient has improved from the second or third day, together with the high incidence of bacteriological eradication failures, is an issue.
authors.affiliation: Second Department of Paediatrics, University of Athens, P & A Kyriakou Children's Hospital, Athens 11527,, Greece. kafetzis@ath.forthnet.gr
authors.forename: Dimitris A
authors.initials: DA
authors.lastname: Kafetzis
authors.forename: Georgia
authors.initials: G
authors.lastname: Liapi
authors.forename: Mariza
authors.initials: M
authors.lastname: Tsolia
authors.forename: Hana
authors.initials: H
authors.lastname: Aoudi
authors.forename: John
authors.initials: J
authors.lastname: Mathioudakis
authors.forename: Irene
authors.initials: I
authors.lastname: Paraskakis
authors.forename: Theodore
authors.initials: T
authors.lastname: Bairamis
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use; D002648:Child; D017291:Clarithromycin / Q000494:pharmacology* / Q000627:therapeutic use; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D010404:Penicillin V / Q000494:pharmacology* / Q000627:therapeutic use; D010612:Pharyngitis / Q000188:drug therapy / Q000382:microbiology*; D011446:Prospective Studies; D012449:Safety; D013290:Streptococcal Infections / Q000188:drug therapy / Q000382:microbiology; D013297:Streptococcus pyogenes / Q000187:drug effects*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D017291:Clarithromycin; D010404:Penicillin V