PORTIER H, BOURILLON A, LUCHT F, CHOUTET F, GEHANNO P, BINGEN E, MEZIANE L; 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. 530).

Ctr. Hosp. Bocage, Dijon, FRANCE

BACKGROUND: A 10-day (d) course of P is the reference antibiotic in GAS tonsillitis. The reports of bacteriological failure rates with P have increased in recent years due to poor compliance.METHODS: 324 children (2-15 years) with acute tonsillitis and a positive test of streptococcal antigen were treated with J bid 5d, or P tid 10d. Clinical assessments and throat cultures were obtained before and at end of treatment (EOT; d 12) and at follow-up (FUP; d 30). Bacterial DNA by RFLP was used to differentiate between persistence (presence of same strain (s) at EOT), relapse (eradication at EOT and acquisition of same s at FUP) and reinfection (eradication at EOT and acquisition of different s at FUP). MICs and PCR amplification were tested to define genetic basis of resistance for erythromycin (E) resistant s. 223 patients were included in bacteriological and clinical per protocol analysis.RESULTS: At EOT, eradication rates were comparable: 82% in J group and 80% in P group, which showed statistical equivalence. Clinical cure rates were 90% and 89%. At FUP, relapse of GAS assessed only on clinical and bacteriological cured patients at EOT occurred in 12% J patients and 12.8% P patients. At inclusion, 20 of 286 clinical isolates (7%) were resistant to E by disk diffusion. MICs confirmed that 7 of 20 s were resistant to E, azithromycin (A), J, clindamycin (C) and streptogramin (MLSB phenotype). These 7 s harboured the erm gene when 13 others were sensitive to J,C, streptogramin but resistant to E and A. All these s harboured the mef gene.CONCLUSION: This study confirms the efficacy of short course of J in GAS tonsillitis previously observed for adult patient.

Publication Types:

• Meeting Abstracts

Keywords:

• Adult
• Anti-Bacterial Agents
• Azithromycin
• Child
• Clindamycin
• Erythromycin
• Humans
• Josamycin
• Microbial Sensitivity Tests
• Penicillin V
• Pharyngitis
• Streptococcus
• Streptococcus agalactiae
• Streptococcus pyogenes
• Streptogramins
• Tonsillitis
• methods

Other ID:

• GWAIDS0008973

UI: 102246470

From Meeting Abstracts