IS PENICILLIN THE APPROPRIATE TREATMENT FOR RECURRENT TONSILLOPHARYNGITIS - RESULTS FROM A COMPARATIVE RANDOMIZED BLIND-STUDY OF CEFUROXIMEAXETIL AND PHENOXYMETHYLPENICILLIN IN CHILDREN
S. Holm et al., IS PENICILLIN THE APPROPRIATE TREATMENT FOR RECURRENT TONSILLOPHARYNGITIS - RESULTS FROM A COMPARATIVE RANDOMIZED BLIND-STUDY OF CEFUROXIMEAXETIL AND PHENOXYMETHYLPENICILLIN IN CHILDREN, Scandinavian journal of infectious diseases, 27(3), 1995, pp. 221-228
The efficacy of cefuroxime axetil compared with phenoxymethylpenicilli
n (PcV) was studied in group A P-haemolytic streptococci (GAS) culture
-proven tonsillitis in children aged 3-12 years with a history of at l
east 1 episode of tonsillopharyngitis requiring antibiotic therapy dur
ing the previous 3 months. This was a comparative, randomized, investi
gator-blind, multicentre study. A total of 236 children received eithe
r cefuroxime axetil suspension or PcV syrup. Inclusion criteria were a
positive, rapid, group A strep test verified by bacteriological cultu
re and clinical signs and symptoms of tonsillopharyngitis. Cefuroxime
axetil treatment gave a significantly higher bacteriological eradicati
on rate and clinical cure rate than PcV. At day 2-5 post treatment the
eradication rates were 99/114 (87%) for cefuroxime axetil vs 61/109 (
56%) for PcV (p < 0.001). The clinical cure rates were 98/114 (86%) an
d 73/109 (67%) respectively (p < 0.01). Up to 21-28 days post-treatmen
t, 9/114 (8%) cefuroxime axetil patients and 37/109 (34%) PcV patients
were treatment failures or had recurrence/reinfection of GAS tonsillo
pharyngitis (p < 0.001). More than 90% of the patients who experienced
bacteriological treatment failure at either the first or second follo
w-up had the same serotype isolated pre- and post-treatment. During th
e study period, 21/114 (18%) patients in the cefuroxime axetil group a
nd 50/109 (46%) patients in the PcV group received additional antibiot
ics (p < 0.001). No serious adverse events were noted and the mild adv
erse events were equally distributed among the patients in the 2 study
groups: 15% for cefuroxime axetil and 14% for PcV.