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Effective short-course treatment of acute group A beta-hemolytic streptococcal tonsillopharyngitis. Ten days of penicillin V vs 5 days or 10 days of cefpodoxime therapy in children. 1994

M E Pichichero, and W M Gooch, and W Rodriguez, and J L Blumer, and S C Aronoff, and R F Jacobs, and J M Musser
Department of Pediatrics, University of Rochester, NY.

OBJECTIVE To compare bacteriologic and clinical efficacy and safety of 10 vs 5 days of cefpodoxime proxetil vs 10 days of penicillin V potassium for the treatment of acute group A beta-hemolytic streptococcal tonsillopharyngitis in children. METHODS Prospective, randomized, observer-blind, multicenter study. METHODS Four hundred eighty-four children (age range, 2 to 17 years) with signs and symptoms of acute tonsillopharyngitis were enrolled; 377 had a positive throat culture for group A beta-hemolytic streptococci and were fully evaluable. One hundred twenty-one patients received cefpodoxime once a day for 10 days, 126 received cefpodoxime twice a day for 5 days, and 130 received penicillin V three times a day for 10 days. RESULTS Cefpodoxime for 10 days vs cefpodoxime for 5 days vs penicillin V for 10 days produced bacteriologic eradication at the end of therapy in 95%, 90%, and 78% of the patients, respectively. The 10- and 5-day cefpodoxime treatment regimens were more efficacious than penicillin V (P = .003 and P = .02, respectively). The cumulative bacteriologic failure rate among assessable patients by the 32- to 38-day posttreatment visit was 20 (17%) of 121 patients who were treated with cefpodoxime for 10 days, 24 (19%) of 125 patients who were treated with cefpodoxime for 5 days, and 45 (35%) of 130 patients who were treated with penicillin V for 10 days (P = .001 and P = .005, respectively). Clinical cure or improvement was observed at the end of therapy in 96%, 94%, and 91% of the patients, respectively (P = not significant). Adverse events were infrequent and similar in all three treatment groups, with minor gastrointestinal side effects predominating. CONCLUSIONS Five days of treatment with cefpodoxime is as efficacious in bacteriologic eradication and clinical response (cure plus improvement) as 10 days of cefpodoxime therapy, and both cefpodoxime regimens produced superior bacteriologic efficacy compared with a 10-day regimen of penicillin V in the treatment of group A beta-hemolytic streptococcal tonsillopharyngitis in children.

UI MeSH Term Description Entries
D010404 Penicillin V A broad-spectrum penicillin antibiotic used orally in the treatment of mild to moderate infections by susceptible gram-positive organisms. Penicillin, Phenoxymethyl,Apocillin,Beromycin,Beromycin, Penicillin,Berromycin, Penicillin,Betapen,Fenoxymethylpenicillin,Pen VK,Penicillin V Potassium,Penicillin V Sodium,Penicillin VK,Phenoxymethylpenicillin,V-Cillin K,Vegacillin,Penicillin Beromycin,Penicillin Berromycin,Phenoxymethyl Penicillin,Potassium, Penicillin V,Sodium, Penicillin V,V Cillin K,V Sodium, Penicillin,VCillin K
D010612 Pharyngitis Inflammation of the throat (PHARYNX). Sore Throat,Pharyngitides,Sore Throats,Throat, Sore
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D004334 Drug Administration Schedule Time schedule for administration of a drug in order to achieve optimum effectiveness and convenience. Administration Schedule, Drug,Administration Schedules, Drug,Drug Administration Schedules,Schedule, Drug Administration,Schedules, Drug Administration
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000097623 Cefpodoxime A third-generation cephalosporin antibiotic. Cefpodoxime contains a methoxy group at C-3 of its cephalosporin core. 5-Thia-1-Azabicyclo(4.2.0)oct-2-ene-2-Carboxylic Acid, 7-(((2-Amino-4-Thiazolyl)(Methoxyimino)Acetyl)Amino)-3-(Methoxymethyl)-8-oxo-, Monosodium Salt, (6R-(6alpha,7beta(Z)))-,Cefpodoxime Sodium,Cefpodoxime Sodium Salt,R 3746,R-3746,RU 51746,RU-51746,U 76253A,U-76,253A,3746, R,51746, RU,76253A, U,R3746,RU51746,Salt, Cefpodoxime Sodium,Sodium Salt, Cefpodoxime,Sodium, Cefpodoxime,U 76,253A,U76,253A
D000208 Acute Disease Disease having a short and relatively severe course. Acute Diseases,Disease, Acute,Diseases, Acute
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D013290 Streptococcal Infections Infections with bacteria of the genus STREPTOCOCCUS. Group A Strep Infection,Group A Streptococcal Infection,Group A Streptococcal Infections,Group B Strep Infection,Group B Streptococcal Infection,Group B Streptococcal Infections,Infections, Streptococcal,Infection, Streptococcal,Streptococcal Infection

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