USE AND EFFICACY OF ERYTHROMYCIN FOR THE TREATMENT OF ACUTE PHARYNGITIS IN CHILDREN

For 40 years penicillin and erythromycin have been the most frequently used antibiotics for the treatment of streptococcal pharyngitis, espe cially caused by Streptococcus beta-hemolyticus. In recent years, seve ral reports have suggested a loss of efficacy of these antibiotics due to progressively increasing resistance. What about Belgium? In order to answer this question, we asked over fifty paediatricians to treat 5 children each with exudative pharyngitis with erythromycin in a daily dose of 50 mg/kg for 10 days. A throat culture before and after treat ment was requested. Between October 1993 and February 1994, 52 paediat ricians included 278 children in this study, 147 boys and 131 girls, w hose mean age was 4 +/- 3 years (mean +/- SD). Data from 16 children ( 6%) were not evaluable. In 19/262 children (7%) no pretreatment throat culture was obtained. In 109 of the remaining 243 children (45%), pre -treatment throat culture was positive for Streptococcus beta-hemolyti cus. In 51 of these children (47%), a post-treatment throat culture wa s obtained; of these 48 (94%) were negative for Streptococcus beta-hem olyticus. The mean duration of treatment was 9 +/- 2 days. Clinical su ccess, defined as absence of symptoms, occurred in 248 of the 262 eval uable patients (95%). The clinical success rate, in children with a po sitive throat culture for Streptococcus beta-hemolytius, was 95 % (104 /109). Resolution of symptoms occurred within 3 +/- 2 days. These resu lts show that the bacterial origin of the treated exudative pharyngiti s was common and that both clinical success and bacterial eradication were remarkably high (95%). We may conclude that in view of its effica cy, the ecology and the cost of treatment, erythromycin remains in Bel gium a drug of first choice for the treatment of exudative pharyngitis in children.