ESPOSITO S, NOVIELLO S, IANNIELLO F, D'ERRICO G; Interscience Conference on Antimicrobial Agents and Chemotherapy.
Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 1999 Sep 26-29; 39: 712 (abstract no. 532).
Dept. Infectious Diseases, Univ. of Naples, ITALY
BACKGROUND: Short-course treatment of streptococcal pharyngotonsillitis (SPT) with oral cephalosporins (cefuroxime axetil, cefpodoxime proxetil, cefixime, cefotiam hexetil) and macrolides (azithromycin, clarithromycin) have been recently investigated, resulting in a substantially similar bacteriologic and clinical cure rate and in a much better compliance when compared to the conventional 10-day course. Cefaclor (CEC), despite its large use for the treatment of SPT, has never been investigated for this purpose.METHODS: In this open randomized study a total of 420 paediatric patients with signs and symptoms of acute pharyngotonsillitis were recruited and in each of them a throat swab was obtained for cultural examination. 138 patients (32.8%) had a positive culture for S. pyogenes and were randomly assigned to receive CEC (25 mg/kg/bid) for a 5- (70 pts = group A) or 10-day (68 pts = group B) course. Patients were assessed clinically and bacteriologically 2-3 days after completing the course and followed up after 20-30 days. All the 420 recruited patients belonged to a 2,800 children's population that, in the six months preceeding the study, had been screened for a pharyngeal streptococcal carrier state. By means of this preliminary screening, we reasonably excluded that the positive throat cultures performed in course of the acute episode of pharyngotonsillitis during the study, could be attributed to a carrier state.RESULTS: At the end of treatment, clinical cure and bacterial eradication was recorded in 92.8% and 92.6% of patients in group A and B respectively. At follow up, the rates of bacteriological recurrence were 4.6% and 4.7% in the 5- and 10-day course groups, respectively. Adverse events (nausea, vomiting, diarrhea) occurred in 10 patients in both groups of treatment (7.2%).CONCLUSION: Short-course therapy with Cefaclor may offer an effective alternative treatment to conventional regimens, with potential for better compliance and reduced costs.
Publication Types:
Keywords:
- Anti-Bacterial Agents
- Azithromycin
- Cefaclor
- Cefixime
- Ceftizoxime
- Cefuroxime
- Cephalosporins
- Child
- Humans
- Pharyngitis
- Respiratory Tract Infections
- Streptococcal Infections
- Streptococcus
- Tonsillitis
- cefpodoxime proxetil
- cefuroxime axetil
- therapy
Other ID:
UI: 102246500
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