title: [Antibiotic therapy against acute tonsillopharyngitis in children due to group A beta-hemolytic streptococci: comparison of clinical efficacy, the bactericidal effects, and effects on oral flora between cefditoren pivoxil for 5 days and amoxicillin for 10 days].
abstract: We compared the clinical efficacy, the bactericidal effects, effect on the oral microbial flora, and adverse reactions between cefditoren pivoxil (CDTR-PI) for 5 days and amoxicillin (AMPC) for 10 days in children with acute group A beta-hemolytic streptococci (GAS) tonsillopharyngitis, and simultaneously examined the emm genotype and drug susceptibility of the isolated GAS. The results showed that the clinical efficacy was 100% for CDTR-PI and 97.9% for AMPC, with no difference between the two groups, and the bacterial elimination rate was 100% in both groups. No serious adverse event was noted in either group. On the other hand, concerning changes in the oral microbial flora between before and after treatment, the amount of bacteria showed no change in the CDTR-PI group (p = 0.5761) but clearly decreased in the AMPC group (p = 0.0049). This indicates that CDTR-PI does not disturb the oral microbial flora compared with AMPC. Also, the emm types determined in the 112 GAS strains isolated in this study were similar to those that have recently been isolated frequently in Japan. Concerning the drug resistance, none of the isolates showed resistance to beta-lactam antibiotics, but 45% of them were resistant to macrolides. The advantages of short-term treatment are considered to include a lower cost, improvement in drug compliance, decrease in the frequency of the occurrence of adverse reactions, decrease in the frequency of the appearance of drug-resistant strains, and alleviation of the psychological burden of patients and their parents. For these reasons, we conclude that CDTR-PI for 5 days is a useful option for the treatment of acute GAS tonsillopharyngitis in children.
authors.affiliation: Department of Pediatrics and Child Health, Kurume University School of Medicine.
authors.forename: Naoki
authors.initials: N
authors.lastname: Tsumura
authors.forename: Kensuke
authors.initials: K
authors.lastname: Nagai
authors.forename: Hidenobu
authors.initials: H
authors.lastname: Hidaka
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Otsu
authors.forename: Yuhei
authors.initials: Y
authors.lastname: Tanaka
authors.forename: Shigeru
authors.initials: S
authors.lastname: Ikezawa
authors.forename: Shinichi
authors.initials: S
authors.lastname: Honma
authors.forename: Shizuo
authors.initials: S
authors.lastname: Shindo
authors.forename: Kimiko
authors.initials: K
authors.lastname: Ubukata
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000658:Amoxicillin / Q000008:administration & dosage* / Q000009:adverse effects / Q000494:pharmacology*; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000494:pharmacology*; D002511:Cephalosporins / Q000008:administration & dosage* / Q000009:adverse effects / Q000494:pharmacology*; D002648:Child; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial; D005260:Female; D005838:Genotype; D006801:Humans; D007223:Infant; D008297:Male; D009055:Mouth / Q000382:microbiology*; D010612:Pharyngitis / Q000188:drug therapy* / Q000382:microbiology*; D013290:Streptococcal Infections; D013297:Streptococcus pyogenes / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification*; D013997:Time Factors; D014069:Tonsillitis / Q000188:drug therapy* / Q000382:microbiology*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D002511:Cephalosporins; C057710:cefditoren pivoxil; D000658:Amoxicillin