title: Symptomatic relapse of group A beta-hemolytic streptococcal tonsillopharyngitis in children.
abstract: The frequency of symptomatic relapses following various antibiotic treatments for group A beta-hemolytic streptococcal tonsillopharyngitis was evaluated in 1080 pediatric patients. Within 5 days of completing therapy, the rank-order frequency of treatment failures was (1) penicillin, (2) amoxicillin, (3) first-generation cephalosporins, (4) beta-lactamase stable cephalosporins and amoxicillin-clavulanate ( P = .005). Retreatment of symptomatic failures resulted in another symptomatic relapse more often with penicillin than with cephalosporins (P = .02). Clinicians should be aware that the rate of symptomatic failures after antibiotic therapy for group A beta-hemolytic streptococcal tonsillopharyngitis differs by drug and is not an uncommon event.
authors.affiliation: University of Rochester School of Medicine, Elmwood Pediatric Group, Rochester, New York, USA. jrcasey@rochester.rr.com
authors.forename: Janet R
authors.initials: JR
authors.lastname: Casey
authors.forename: Michael E
authors.initials: ME
authors.lastname: Pichichero
mesh_terms: D000293:Adolescent; D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001426:Bacterial Proteins / Q000302:isolation & purification*; D002434:Cefadroxil / Q000627:therapeutic use; D002506:Cephalexin / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D006460:Hemolysin Proteins / Q000302:isolation & purification*; D006801:Humans; D010406:Penicillins / Q000627:therapeutic use; D010612:Pharyngitis / Q000188:drug therapy* / Q000382:microbiology; D012189:Retrospective Studies; D055502:Secondary Prevention; D013290:Streptococcal Infections / Q000175:diagnosis / Q000188:drug therapy*; D014069:Tonsillitis / Q000188:drug therapy* / Q000382:microbiology; D017211:Treatment Failure; D001618:beta-Lactamases / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D006460:Hemolysin Proteins; D010406:Penicillins; C071495:streptococcal group B hemolysin; D002434:Cefadroxil; D000658:Amoxicillin; D001618:beta-Lactamases; D002506:Cephalexin