In a randomized multicenter study, the efficacy and safety of
cefprozil were compared with those of
penicillin in the treatment of group A streptococcal tonsillopharyngitis in children. Of the 409 patients enrolled, 323 were evaluable for their clinical and bacteriological responses; of these 323 children, 172 received
cefprozil and 151 received
penicillin V. The clinical responses in patients treated with
cefprozil were significantly better than those in patients who received
penicillin (95.3 versus 88.1%; P = 0.023). Eradication of the original serotype of group A streptococci was achieved in 91.3% of patients treated with
cefprozil and 87.4% of patients treated with
penicillin, the difference not being statistically significant (P = 0.125). However, there were significantly more symptomatic patients among the bacteriological failures in the
penicillin group (68.4%) than in the
cefprozil group (26.7%).
beta-Lactamase-producing Staphylococcus aureus was more frequently isolated from the throat flora during
penicillin therapy than during
cefprozil treatment. No difference in the incidence of adverse events probably related or of unknown relationship to the study drugs was observed in the two treatment groups (5.2% of those treated with
cefprozil and 6.0% of those treated with
penicillin).
Cefprozil can be considered a safe and reliable
drug for the treatment of streptococcal
pharyngitis in children.