COMPARATIVE EFFICACY AND SAFETY OF 4-DAY CEFUROXIME AXETIL AND 10-DAYPENICILLIN TREATMENT OF GROUP-A BETA-HEMOLYTIC STREPTOCOCCAL PHARYNGITIS IN CHILDREN

In a prospective randomized multicenter study, 308 children, ages 2 to 15 years, were randomized to receive either cefuroxime axetil suspens ion (N = 152; 20 mg/kg/day twice daily) for 4 days, penicillin suspens ion (N = 156; 45 mg/kg/day divided three times daily) for 10 days, of whom 97 and 103, respectively, had culture-proved group A beta-hemolyt ic Streptococcus infection. Two to 4 days after completion of the trea tment, group A beta-hemolytic Streptococcus were eradicated from 85 of 97 (87.6%) children taking cefuroxime and from 90 of 103 (87.4%) taki ng penicillin; respective clinical cure rates were 94.8% and 96.1%, Cl inical signs and symptoms resolved significantly more rapidly with cef uroxime (P < 0.05). At 28 to 32 days posttreatment the eradication of the primary isolate was confirmed in 94.4 and 91.9% of cefuroxime axet il and penicillin-treated patients, respectively, Drug-related adverse events (mainly gastrointestinal and cutaneous reactions) were reporte d in 2.1 and 2.7% of the cefuroxime- and penicillin-treated patients, respectively, Results indicated that a 4-day treatment with cefuroxime axetil was as effective and well-tolerated as the conventional 10-day treatment with penicillin in children with acute group A beta-hemolyt ic Streptococcus pharyngitis.