Cefprozil is a new oral
cephalosporin with an in vitro spectrum of activity that includes group A beta-hemolytic streptococci (Streptococcus pyogenes). Three multicenter, randomized trials were conducted for comparing the clinical efficacy and safety of
cefprozil administered once or twice daily with that of
cefaclor,
penicillin, or
erythromycin ethylsuccinate administered three or four times daily in the treatment of mild-to-moderate tonsillopharyngitis. In the
cefprozil-
cefaclor trial, the pathogen eradication rate for evaluable patients receiving
cefprozil was 83%, which was significantly better than that for patients receiving
cefaclor (76%) (P = .035). The rate of satisfactory clinical response was similar with
cefprozil (89%) and
cefaclor (84%). The overall response rate was significantly better with
cefprozil (80%) than with
cefaclor (72%, P = .018). Differences in response rates were not noted when analyzing only patients 2-12 years of age. In the
cefprozil-
penicillin trial, the eradication rate of bacteriologic pathogens was similar in patients receiving
cefprozil (91%) and in patients receiving
penicillin (87%). A satisfactory clinical response was seen in 95% of the evaluable
cefprozil-treated patients, which was significantly better than the rate of satisfactory clinical response seen in the
penicillin-treated patients (88%; P = .023). In addition, during-
therapy cultures for
penicillin-treated patients yielded a significantly higher rate of
beta-lactamase-producing Staphylococcus aureus than did those for the group of
cefprozil-treated patients (13% vs. 4.5%, respectively; P = .046). Significantly more clinically symptomatic bacteriologic failures occurred in the
penicillin group (P = .037).(ABSTRACT TRUNCATED AT 250 WORDS)