Occurrence of group A β-hemolytic streptococcal pharyngitis in the four months after treatment of an index episode with amoxicillin once-daily or twice-daily or with cephalexin.

Abstract

BACKGROUND:

Prospective studies using bacterial eradication as the endpoint have demonstrated that once-daily amoxicillin is as effective as twice-daily amoxicillin for treatment of group A β-hemolytic streptococcal (GABHS) pharyngitis.

OBJECTIVE:

The aim of this study was to determine, in a retrospective study, whether treatment of symptomatic GABHS pharyngitis with once-daily amoxicillin was as effective in preventing clinical recurrences as twice-daily amoxicillin or cephalexin in pediatric office practice, using patient-initiated return visits for streptococcal pharyngitis as a pragmatic, clinical endpoint.

METHODS:

The charts of consecutive patients 2 years of age and older with laboratory-proven GABHS pharyngitis for a period of 2 years were reviewed to identify index cases of streptococcal pharyngitis and subsequent episodes. Age, weight, antibiotic treatment and time from index to subsequent episodes of GABHS pharyngitis were recorded.

RESULTS:

In 1402 index episodes, patients received amoxicillin once-daily (231), amoxicillin twice-daily (846) or cephalexin (325). The risk of symptomatic streptococcal pharyngitis in the 4 months after treatment of the index episode was not statistically different among the 3 treatment groups: amoxicillin once-daily (15.1%), amoxicillin twice-daily (19.6%) and cephalexin (19.1%). There was a trend toward reduction in the risk of recurrences in the 6 weeks after completion of antibiotics in the cephalexin (9%) group compared with the combined amoxicillin (13%) groups.

CONCLUSIONS:

Amoxicillin once-daily or twice-daily was equally effective in terms of frequency of recurrence of symptomatic GABHS pharyngitis.

• Authors: Carlos E Armengol, J Owen Hendley
• Journal: The Pediatric infectious disease journal (Pediatr Infect Dis J) Vol. 31 Issue 11 Pg. 1124-7 (Nov 2012) ISSN: 1532-0987 [Electronic] United States
• PMID: 22668807 (Publication Type: Journal Article)

Chemical References

• Anti-Bacterial Agents
• Amoxicillin
• Cephalexin

Topics

• Amoxicillin (administration & dosage, therapeutic use)
• Anti-Bacterial Agents (administration & dosage, therapeutic use)
• Cephalexin (administration & dosage, therapeutic use)
• Child
• Child, Preschool
• Drug Administration Schedule
• Drug Therapy, Combination
• Humans
• Pharyngitis (drug therapy, microbiology)
• Retrospective Studies
• Streptococcal Infections (drug therapy, microbiology)
• Streptococcus pyogenes