Two Dosages of Clarithromycin for Five Days, Amoxicillin/Clavulanate for Five Days or Penicillin V for Ten Days in Acute Group A Streptococcal Tonsillopharyngitis
| Autor: | Bülent Bozdogan, George D. Katopodis, Ioanna N. Grivea, Nicholas G. Beratis, Dimitra I Kritikou, George A. Syrogiannopoulos, Peter C Applebaum, Lois M. Ednie |
|---|---|
| Rok vydání: | 2004 |
| Předmět: |
Male
Microbiology (medical) medicine.medical_specialty Adolescent Streptococcus pyogenes medicine.drug_class Antibiotics Amoxicillin-Potassium Clavulanate Combination Risk Assessment Severity of Illness Index Gastroenterology Drug Administration Schedule Reference Values Clarithromycin Streptococcal Infections Clavulanic acid Internal medicine polycyclic compounds medicine Humans Child Tonsillopharyngitis Probability Antibacterial agent Dose-Response Relationship Drug business.industry Pharyngitis Amoxicillin Surgery Penicillin Tonsillitis Phenoxymethylpenicillin Treatment Outcome Infectious Diseases Child Preschool Acute Disease Pediatrics Perinatology and Child Health Penicillin V Female business Follow-Up Studies medicine.drug |
| Zdroj: | Pediatric Infectious Disease Journal. 23:857-865 |
| ISSN: | 0891-3668 |
| DOI: | 10.1097/01.inf.0000138080.74674.a2 |
| Popis: | Short course antimicrobial therapy is suggested for group A streptococcal tonsillopharyngitis.The bacteriologic and clinical efficacies of clarithromycin [30 or 15 mg/kg/day twice daily (b.i.d.)] or amoxicillin/clavulanate (43.8/6.2 mg/kg/day b.i.d.) for 5 days or penicillin V (30 mg/kg/day 3 times a day) for 10 days were compared. In a randomized, open label, parallel group, multicenter study, 626 children (2-16 years old) with tonsillopharyngitis were enrolled; 537 were evaluable for efficacy. Follow-up evaluations were performed at 4-8 and 21-28 days after therapy.At enrollment, 26% of the Streptococcus pyogenes isolates were clarithromycin-nonsusceptible. All regimens had an apparently similar clinical efficacy. The long term S. pyogenes eradication rates were 102 of 123 (83%) with amoxicillin/clavulanate and 88 of 114 (77%) with penicillin V. In the 30- and 15-mg/kg/day clarithromycin groups, eradication occurred in 71 of 86 (83%) and 59 of 80 (74%) of the clarithromycin-susceptible isolates (P = 0.33), and in 4 of 28 (14%) and 5 of 26 (19%) of the clarithromycin-resistant isolates, respectively (clarithromycin-susceptible versus -resistant, P0.0001). Both clarithromycin dosages were well-tolerated.In group A streptococcal tonsillopharyngitis, 5 days of clarithromycin or amoxicillin/clavulanate treatment had clinical efficacy comparable with that of 10 days of penicillin V treatment; however, amoxicillin/clavulanate and penicillin V were bacteriologically more effective than clarithromycin because of its failure to eradicate the clarithromycin-resistant S. pyogenes isolates. The 5-day clarithromycin regimens are not recommended for treatment of streptococcal tonsillopharyngitis in areas where in vitro resistance of group A streptococci to clarithromycin is common. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|