Efficacy of benzathine penicillin G in group A streptococcal pharyngitis: reevaluation.

Abstract

The rate of streptococcal eradication after intramuscular administration of benzathine penicillin G in 66 children with acute group A streptococcal pharyngitis was determined and possible reasons for treatment failure explored. Bacteriologic treatment failure, defined as isolation of the same serotype at 3- or 6-weeks follow-up, occurred in eight (12%) patients. The treatment failure rate was 21% in those with immunologically significant infection, versus 8% in those without antibody rises (P greater than 0.1). All group A beta-hemolytic streptococcal (GABS) strains isolated from patients with treatment failure, both before and after benzathine penicillin G therapy, were exquisitely susceptible to penicillin G (minimum inhibitory concentration less than or equal to 0.02 microgram/mL), and none showed evidence of tolerance (minimum bactericidal concentration less than or equal to 0.04 microgram/mL). Thus, we found GABS eradication rates to exceed 10% in children given benzathine penicillin G. The failure rate did not appear to be related to enrichment of the patient population with a high proportion of asymptomatic carriers nor to the presence of penicillin-tolerant GABS.

• Authors: S Feldman, A L Bisno, L Lott, R Dodge, R E Jackson
• Journal: The Journal of pediatrics (J Pediatr) Vol. 110 Issue 5 Pg. 783-7 (May 1987) ISSN: 0022-3476 [Print] United States
• PMID: 3553513 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Penicillin G
• Penicillin G Benzathine

Topics

• Child
• Follow-Up Studies
• Humans
• Penicillin G (therapeutic use)
• Penicillin G Benzathine (therapeutic use)
• Pharyngitis (drug therapy, etiology)
• Pharynx (microbiology)
• Streptococcal Infections (drug therapy)
• Streptococcus pyogenes (drug effects, isolation & purification)
• Time Factors