This study evaluated the safety and efficacy of
clarithromycin in the treatment of patients with Group A beta-hemolytic streptococcal
pharyngitis. Subjects were treated with either 250 mg
clarithromycin twice daily or 250 mg
penicillin V four times a day for 10 days and followed for approximately three weeks post-treatment. At the completion of
therapy, 96% (45/47) of patients treated with
clarithromycin and 89% (43/48) of patients treated with
penicillin V were clinically cured or improved. Recurrence of symptoms occurred in 7 and 5 patients who were treated with
clarithromycin and
penicillin V respectively. Initial bacteriologic eradication was observed in all but one patient. Recurrence of Streptococcus pyogenes occurred in 5 (11%) patients who received
clarithromycin and 7 (15%) patients who received
penicillin V. The majority of adverse events reported during this study were mild and involved the gastrointestinal tract.
Diarrhea was more frequent in patients who received
clarithromycin. In this multicenter, randomized, double-blind trial,
clarithromycin was as safe and effective as
penicillin V in the treatment of Streptococcus pyogenes throat
infections.