5 VERSUS 10 DAYS TREATMENT OF STREPTOCOCCAL PHARYNGOTONSILLITIS - A RANDOMIZED CONTROLLED TRIAL COMPARING CEFPODOXIME PROXETIL AND PHENOXYMETHYL PENICILLIN

A total of 220 adults and children >10 years old (mean 29.5 +/- 11.7 y ears) with pharyngitis/tonsillitis were randomized to receive either c efpodoxime proxetil 100 mg bid for 5 days (n = 113) or phenoxymethyl p enicillin, 600 mg tid for 10 days (n = 107). At the end of treatment o f the 166 evaluable patients, a satisfactory clinical response was obt ained in 85/88 (96.6%) patients treated with cefpodoxime proxetil and in 75/78 (96.1%) treated with phenoxymethyl penicillin. Group A P-hemo lytic streptococci (GABHS) eradication was similar in both groups: 79/ 82 (96.3%) patients in the cefpodoxime proxetil group and 64/68 (94.1% ) patients in the phenoxymethyl penicillin group. At follow-up (20-30 days after the end of treatment) the GABHS eradication persisted in 67 /72 (93.1%) patients treated with cefpodoxime proxetil and in 56/61 (9 1.8%) patients treated with phenoxy, methyl penicillin. Significantly better compliance (p<0.01) was noticed with the cefpodoxime proxetil r egimen compared with the phenoxymethyl penicillin regimen, with only 2 /110 (2%) poorly compliant patients in the cefpodoxime proxetil group vs 17/104 (16%) in the phenoxymethyl penicillin group. Thus, the short er duration of therapy, in conjunction with demonstrated clinical and bacteriological efficacy that is equivalent to standard therapy, makes cefpodoxime proxetil an acceptable alternative for the treatment of G ABHS pharyngitis/tonsillitis.