Ceftibuten vs. penicillin V in group A beta-hemolytic streptococcal pharyngitis. Members of the Ceftibuten Pharyngitis International Study Group.

Abstract

The efficacy and safety of a 10-day course of ceftibuten oral suspension (9 mg/kg once daily) were compared with those of penicillin V (25 mg/kg/day in 3 divided doses) in children 3 to 18 years old treated for symptomatic pharyngitis and scarlet fever caused by group A beta-hemolytic streptococci (Streptococcus pyogenes). The study was prospective, randomized, multicenter and investigator-blinded; patients were randomized in a 2:1 ratio (ceftibuten:penicillin V). Overall clinical success (cure/improvement) at the primary end point of treatment (5 to 7 days posttherapy) was achieved in 97% (285 of 294) of ceftibuten-treated patients vs. 89% (117 of 132) of penicillin V-treated patients (P < 0.01). Elimination of infecting streptococci 5 to 7 days posttherapy was achieved in 91% (267 of 294) of ceftibuten-treated patients vs 80% (105 of 132) of penicillin V-treated patients (P < 0.01). A significant rise in anti-streptolysin O or anti-DNase B was observed in approximately 30% of patients in both treatment groups. No patient developed rheumatic fever or nephritis. Treatment-related adverse events were similar between the two groups; mild vomiting (2%) was most frequently reported. These data suggest that once daily ceftibuten is as safe as and more effective than three times daily penicillin V for the treatment of group A beta-hemolytic streptococcal pharyngitis.

• Authors: M E Pichichero, S E Mclinn, W M Gooch 3rd, W Rodriguez, J Goldfarb, B E Reidenberg
• Journal: The Pediatric infectious disease journal (Pediatr Infect Dis J) Vol. 14 Issue 7 Suppl Pg. S102-7 (Jul 1995) ISSN: 0891-3668 [Print] United States
• PMID: 7567309 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial)

Chemical References

• Cephalosporins
• DNA, Bacterial
• Penicillins
• Suspensions
• Ceftibuten
• Penicillin V

Topics

• Adolescent
• Ceftibuten
• Cephalosporins (administration & dosage, adverse effects, therapeutic use)
• Child
• Child, Preschool
• Confidence Intervals
• DNA, Bacterial (analysis)
• Double-Blind Method
• Female
• Humans
• Male
• Penicillin V (administration & dosage, adverse effects, therapeutic use)
• Penicillins (administration & dosage, adverse effects, therapeutic use)
• Pharyngitis (drug therapy, microbiology)
• Prospective Studies
• Scarlet Fever (drug therapy)
• Streptococcal Infections (drug therapy)
• Streptococcus pyogenes (isolation & purification)
• Suspensions
• Treatment Outcome