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Comparative efficacy and safety of cefprozil versus penicillin, cefaclor and erythromycin in the treatment of streptococcal pharyngitis and tonsillitis.

Abstract
Cefprozil is a new oral cephalosporin with an enhanced in vitro spectrum of activity that includes group A beta-hemolytic streptococci (GABHS). Four multicenter randomized clinical trials were conducted to compare the clinical efficacy and safety of cefprozil administered once or twice a day for the treatment of mild to moderate GABHS tonsillitis and pharyngitis. A total of 1597 patients were enrolled in the trials. Patient demographics and severity of infection were similar for all treatment groups. In Study 1, cefprozil administered at 20 mg/kg once daily was clinically, in 68 of 76 patients (89%) and bacteriologically, in 66 of 74 patients (89%) superior to penicillin -51 of 69 (74%) and 46 of 69 (67%)--administered three times a day in patients of two to 12 years of age. In Study 2, the patients enrolled were 13 years of age and older, and cefprozil administered at 20 mg/kg once a day had similar clinical (93% vs. 90%) and bacteriological (95% vs. 94%) response rates as cefaclor administered three times a day. Study 3 demonstrated that cefprozil administered twice daily was similar to penicillin given three times a day, the clinical satisfactory response being 164 of 175 (94%) for cefprozil and 146 of 165 (88%) for penicillin. In Study 4, identical clinical and bacteriologic responses (95%) were observed for cefprozil administered once a day and erythromycin ethylsuccinate administered four times a day in children over two years of age. There were no significant differences in the incidence or severity of drug-related adverse events, which, when reported, were mild and transient.(ABSTRACT TRUNCATED AT 250 WORDS)
AuthorsJ M McCarty
JournalEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology (Eur J Clin Microbiol Infect Dis) Vol. 13 Issue 10 Pg. 846-50 (Oct 1994) ISSN: 0934-9723 [Print] Germany
PMID7889958 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial, Review)
Chemical References
  • Anti-Bacterial Agents
  • Cephalosporins
  • Penicillins
  • cefprozil
  • Erythromycin
  • Cefaclor
Topics
  • Adolescent
  • Adult
  • Aged
  • Anti-Bacterial Agents (therapeutic use)
  • Cefaclor (therapeutic use)
  • Cephalosporins (therapeutic use)
  • Child
  • Child, Preschool
  • Erythromycin (therapeutic use)
  • Female
  • Humans
  • Male
  • Middle Aged
  • Multicenter Studies as Topic
  • Penicillins (therapeutic use)
  • Pharyngitis (drug therapy)
  • Randomized Controlled Trials as Topic
  • Streptococcal Infections (drug therapy)
  • Streptococcus pyogenes (drug effects)
  • Tonsillitis (drug therapy)

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