Rate of eradication of group A beta-hemolytic streptococci in children with pharyngo-tonsillitis by amoxicillin and cefdinir.
BACKGROUND
Cephalosporins were found to be more effective than penicillins in the eradication of group A beta-hemolytic streptococcal (GABHS) from tonsillar tissues. This study investigated the effect of amoxicillin and cefdinir therapies on the rate of eradication of GABHS from the tonsils of children with acute pharyngo-tonsillitis (PT).


METHODS
Of 50 children suffering from PT 25 were treated with amoxicillin (40 mg/(kg d) or 250 mg every 8 h) and 25 with cefdinir (14 mg/(kg d) or 600 mg once a day) for 10 days. Pharyngo-tonsillar cultures were obtained from all children before treatment and on the 1st, 2nd, 3rd, 4th, 7th, and 12th days.


RESULTS
GABHS was eradicated more rapidly from children treated with cefdinir as compared to those receiving amoxicillin. A smaller number of patients with GABHS were found in those treated with cefdinir as compared to amoxicillin throughout the treatment period. Eradication of GABHS from 68% (8 of 25 patients) was noted in those treated with cefdinir after 2 days and those treated with amoxicillin after 4 days. The differences between the number of patients who had a bacteriological cure between those receiving cefdinir to those getting amoxicillin was statistical significant at day 4 (32% vs. 8%). At the end of therapy GABHS was recovered from 5 (20%) and 2 (8%) of the patients. The group that received cefdinir, had a more rapid reduction in fever on the first after initiation of therapy as compared to those receiving amoxicillin. The fever reduction in those receiving cefdinir occurred a day earlier than in those getting amoxicillin.


CONCLUSIONS
Fever was reduced and GABHS was eradicated more rapidly from children treated with cefdinir as compared to amoxicillin.
Brook
Itzhak
I
Department of Pediatrics, Georgetown University, Schools of Medicine, Washington, DC 20016, USA. ib6@georgetown.edu
Gober
Alan E
AE
D000208:Acute Disease; D000658:Amoxicillin / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000077525:Cefdinir; D002511:Cephalosporins / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D004359:Drug Therapy, Combination; D005260:Female; D005334:Fever / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D006461:Hemolysis / Q000502:physiology*; D006801:Humans; D008297:Male; D010612:Pharyngitis / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D013290:Streptococcal Infections / Q000150:complications* / Q000188:drug therapy*; D013297:Streptococcus pyogenes / Q000302:isolation & purification*; D013997:Time Factors; D014069:Tonsillitis / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology
D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D000658:Amoxicillin; D000077525:Cefdinir