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Failure to eradicate Group A beta-haemolytic streptococci (GABHS) from the upper respiratory tract after antibiotic treatment.

Abstract
The clinical efficacy, safety and bacteriological eradication of Group A beta-haemolytic streptococci (GABHS) from the throat was studied after treatment of streptococcal tonsillopharyngitis with three commonly used oral antibiotics in a prospective, open labelled, comparative, randomised trial of 265 evaluable patients seen in one centre. All three antibiotics were administered in the recommended doses; penicillin V q8 hourly and clarithromycin q12 hourly were given for 10 days and cefprozil q12 hourly for 5 days. Clinical results and adverse events were similar for all three antibiotics used, with a prompt clinical outcome of >95%. Cefprozil had the best bacteriological eradication rate (failed to eradicate: 13.2, 15.1, 2.3; relapses: 13.2, 11.4, 5.7%, for penicillin, clarithromycin and cefprozil, respectively). Oral penicillin remains a clinically effective and safe antibiotic for the treatment of streptococcal pharyngitis. However, compliance and convenience for parents and children when they are asked to follow a 10 days course, especially when the patient has improved from the second or third day, together with the high incidence of bacteriological eradication failures, is an issue.
AuthorsDimitris A Kafetzis, Georgia Liapi, Mariza Tsolia, Hana Aoudi, John Mathioudakis, Irene Paraskakis, Theodore Bairamis
JournalInternational journal of antimicrobial agents (Int J Antimicrob Agents) Vol. 23 Issue 1 Pg. 67-71 (Jan 2004) ISSN: 0924-8579 [Print] Netherlands
PMID14732316 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial)
Chemical References
  • Anti-Bacterial Agents
  • Clarithromycin
  • Penicillin V
Topics
  • Anti-Bacterial Agents (pharmacology, therapeutic use)
  • Child
  • Clarithromycin (pharmacology, therapeutic use)
  • Drug Administration Schedule
  • Female
  • Humans
  • Male
  • Microbial Sensitivity Tests
  • Penicillin V (pharmacology, therapeutic use)
  • Pharyngitis (drug therapy, microbiology)
  • Prospective Studies
  • Safety
  • Streptococcal Infections (drug therapy, microbiology)
  • Streptococcus pyogenes (drug effects)
  • Treatment Outcome

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