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Five-day cefdinir treatment for streptococcal pharyngitis. Cefdinir Pharyngitis Study Group.

Abstract
A multicenter, randomized, controlled, investigator-blind study was performed to evaluate the safety and efficacy of oral cefdinir versus oral penicillin V for the treatment of pharyngitis due to group A beta-hemolytic streptococci (GABHS). Patients 13 years of age and older were randomized to receive either oral cefdinir (300 mg twice a day) for 5 days followed by placebo for 5 days or oral penicillin V (250 mg four times a day) for 10 days. Throat cultures were obtained, and signs and symptoms of pharyngitis were recorded at study admission and follow-up visits on study days 11 to 15, 16 to 20, and 25 to 31. Patients kept a diary to record medication intake and their assessment of throat pain at admission and at each day of study treatment. Five hundred fifty-eight patients were enrolled, of whom 432 (77.4%) were clinically and microbiologically evaluable. The GABHS eradication rates 5 to 10 days after completion of therapy were 193 of 218 (88.5%) in the cefdinir group and 176 of 214 (82.2%) in the penicillin group (P = 0.053). Clinical cure rates were 89.0 and 84.6%, respectively (P = 0.80). By the time of the long-term follow-up visit, 2 to 3 weeks after completion of treatment, 156 of 191 (81.7%) of the assessable cefdinir patients and 152 of 195 (77.9%) of the penicillin patients remained free of GABHS. Both treatments were well tolerated, with adverse reaction rates of 18.3% in the cefdinir study arm and 15.0% in the penicillin study arm (P = 0.278). Five-day treatment with cefdinir is safe and effective therapy for GABHS pharyngitis. Based on its twice-a-day dosage and shorter course of therapy, leading to potentially greater patient compliance, cefdinir may be considered for use in the treatment of pharyngitis caused by GABHS.
AuthorsK J Tack, D C Henry, W M Gooch, D N Brink, C H Keyserling
JournalAntimicrobial agents and chemotherapy (Antimicrob Agents Chemother) Vol. 42 Issue 5 Pg. 1073-5 (May 1998) ISSN: 0066-4804 [Print] United States
PMID9593129 (Publication Type: Clinical Trial, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
Chemical References
  • Cephalosporins
  • Cefdinir
Topics
  • Administration, Oral
  • Adolescent
  • Adult
  • Aged
  • Cefdinir
  • Cephalosporins (administration & dosage, therapeutic use)
  • Double-Blind Method
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pharyngitis (drug therapy, microbiology)
  • Streptococcal Infections (drug therapy)
  • Streptococcus pyogenes (drug effects)

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