This paper is only available as a PDF. To read, Please Download here.
Abstract
The present study was undertaken to compare the efficacy and safety of a new regimen
of cefaclor (25 mg/kg BID) with amoxicillin-clavulanate and erythromycin TID at standard
doses for the treatment of pediatric patients with acute pharyngotonsillitis (APT).
A total of 673 children (age range, 2 to 12 years) with signs and symptoms of APT
were enrolled; 245 of these children who had a positive throat culture for group A
beta-hemolytic streptococci (GABHS) entered the study and were randomly assigned to
receive cefaclor 25 mg/kg BID, amoxicillin-clavulanate 15 mg/kg TID, or erythromycin
15 mg/kg TID. A 10-day antibiotic course was prescribed for each patient. Clinical
and bacteriologic responses were assessed at the end of treatment (day 10) and at
the follow-up visit (day 30). All GABHS strains isolated from throat cultures were
tested for in vitro sensitivity to the antibiotics used in the study. Side effects
(mainly nausea) were rare and mild in each group and did not require discontinuation
of therapy. No GABHS strain was resistant to cefaclor or to amoxicillin-clavulanate;
37.9% of the strains were resistant to erythromycin. The results indicated that cefaclor
given BID seems to be as effective as amoxicillin-clavulanate given TID (cure rate,
91.9% and 90.5%, respectively) and more effective than erythromycin given TID (cure
rate, 76.8%) for the treatment of patients with APT. Erythromycin resistance among
GABHS is an emerging problem in many geographic areas.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Clinical TherapeuticsAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- A profile of pediatric practice in the United States.Am J Dis Child. 1983; 137: 1057-1060
- Febrile exudative tonsillitis: Viral or streptococcal.Pediatrics. 1987; 10: 6-12
- Role of beta-lactamase producing bacteria in the failure of penicillin to eradicate group A streptococci.Pediatr Infect Dis J. 1985; 4: 491-495
- Evaluation of beta-lactamase activity and microbial interference in treatment failures of acute streptococcal tonsillitis.Scand J Infect Dis. 1986; 18: 313-319
- Comparison of oral cephalosporins with penicillin therapy for group A streptococcal pharyngitis.Pediatr Infect Dis J. 1986; 5: 649-654
- Antibiotic management of group A streptococcal pharyngo-tonsillitis.Pediatr Infect Dis J. 1991; 10 (Suppl 10): s43-s49
- A comparison of cephalosporins and penicillins in the treatment of group A beta-hemolytic streptococcal pharyngitis: A meta-analysis supporting the concept of microbial copathogenicity.Pediatr Infect Dis J. 1991; 10: 275-281
- 5th ed. Performance Standards for Antimicrobial Disk Susceptibility Tests. NCCLS, Villanova, PA1995
- Recognition of streptococcal pharyngitis in adults.Arch Intern Med. 1975; 135: 1493-1497
- A simple score card for the tentative diagnosis of streptococcal pharyngitis.Am J Dis Child. 1977; 131: 514-517
- Throat culture and rapid test for rapid diagnosis of group A streptococcal pharyngitis.Ann Intern Med. 1986; 105: 892-899
- The prediction of streptococcal pharyngitis in adults.J Intern Med. 1986; 1: 1-7
- The accuracy of experienced physicians' probability estimates for patients with sore throats.JAMA. 1985; 254: 925-929
- Nonstreptococcal pharyngitis.J Pediatr. 1968; 73: 51-60
- Cost-benefit of throat swab in pharyngitis.Med Hygiene. 1996; 54: 1901-1905
- Failure of penicillin to eradicate group A streptococci during an outbreak of pharyngitis.Lancet. 1980; i: 498-501
- Treatment of group A streptococcal pharyngitis in children.Am J Dis Child. 1971; 121: 477-480
- Randomized, single-blind evaluation of cefadroxil and phenoxymethyl penicillin in the treatment of streptococcal pharyngitis.Antimicrob Agents Chemother. 1987; 31: 903-906
- Efficacy of benzathin penicillin G in group A streptococcal pharyngitis: Reevaluation.J Pediatr. 1987; 110: 783-787
- Association of penicillin tolerance with failure to eradicate group A streptococci from patients with pharyngitis.J Pediatr. 1985; 107: 681-684
- Efficacy of beta-lactamase resistant penicillin and influence of penicillin tolerance in eradicating streptococci from the pharynx after failure of penicillin therapy for group A streptococcal pharyngitis.J Pediatr. 1987; 110: 777-782
- Prevention of rheumatic fever. A statement for health professionals by the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease of the Council on Cardiovascular Disease in the Young, The American Heart Association.Circulation. 1986; 78: 1082-1086
- Group A streptococcal infections.in: Peter E 22nd ed. Report of the Committee on Infectious Diseases. American Academy of Pediatrics, Elk Grove Village, Ill1991: 438-447
- Erythromycin therapy for group A streptococcal pharyngitis.Am J Dis Child. 1984; 138: 536-539
- Evaluation of cefadroxil, penicillin and erythromycin in the treatment of streptococcal pharyngo-tonsillitis.Pediatr Infect Dis J. 1991; 10 (Suppl): S61-S63
- Osservatorio epidemiologico sulle resistenze di Streptococcus pyogenes a macrolidi e lincosamidi.Infezioni Med. 1996; 2: 74-78
- Impiego del cefaclor nella faringite streptococcica.Presented at Convegno Nazionale di Antibioticoterapia in età Pediatrica. 15161990; (Milan, Italy)
Dillon HC, Disney FA, McLinn SE, et al. A multiclinic study for the evaluation of cefaclor TID and BID dosage regimens in the treatment of bacterial pharyngitis. Protocol 83. Data on file, Eli Lilly, Indianapolis, Indiana.
Article info
Identification
Copyright
© 1998 Published by Elsevier Inc.
