5 DAYS OF ERYTHROMYCIN ESTOLATE VERSUS 10 DAYS OF PENICILLIN-V IN THETREATMENT OF GROUP-A STREPTOCOCCAL TONSILLOPHARYNGITIS IN CHILDREN

In a randomized, prospective, multicenter trial, 227 children ranging in age from 3 to 17 years who had tonsillopharyngitis and a throat cul ture positive for group A beta-hemolytic streptococci (GABHS) were tre ated with erythromycin estolate (40 mg/kg/d in two divided doses for f ive days) or penicillin V (30 mg/kg/d in three divided doses for ten d ays), Clinical signs and symptoms of tonsillopharyngitis were recorded , and throat cultures were obtained before treatment as well as one to three days and six weeks after treatment, Clinical success (cure and improvement) was observed on days 6 to 8 in 100 of 102 (98%) assessabl e children treated with erythromycin estolate and on days 11 to 13 in 97 of 99 (98%) assessable children treated with penicillin V, Of all p atients showing clinical success, 11 were rated as improved, all of wh om were treated with erythromycin estolate, There was a trend towards increased use of analgesic treatment in the erythromycin estolate grou p (41% vs 33%), On completion of treatment, the rate of eradication of GABHS was 83.3% in the erythromycin estolate group compared with 87.9 % in the penicillin V group, The difference is not significant but doe s not take into account patients excluded because of erythromycin resi stance (3.7%), Clinical recurrence was observed in 11 (10.8%) patients treated with erythromycin estolate and in 6 (6.1%) patients treated w ith penicillin V (non-significant difference), Compliance in the eryth romycin estolate group was statistically superior to that in the penic illin V group, The incidence and nature of adverse events were similar in both treatment groups.