CEFPROZIL VERSUS PENICILLIN-V IN TREATMENT OF STREPTOCOCCAL TONSILLOPHARYNGITIS

In a randomized multicenter study, the efficacy and safety of cefprozi l were compared with those of penicillin in the treatment of group A s treptococcal tonsillopharyngitis in children. Of the 409 patients enro lled, 323 were evaluable for their clinical and bacteriological respon ses; of these 323 children, 172 received cefprozil and 151 received pe nicillin V. The clinical responses in patients treated with cefprozil were significantly better than those in patients who received penicill in (95.3 versus 88.1%; P = 0.023). Eradication of the original serotyp e of group A streptococci was achieved in 91.3% of patients treated wi th cefprozil and 87.4% of patients treated with penicillin, the differ ence not being statistically significant (P = 0.125). However, there w ere significantly more symptomatic patients among the bacteriological failures in the penicillin group (68.4%) than in the cefprozil group ( 26.7%). Beta-Lactamase-producing Staphylococcus aureus was more freque ntly isolated from the throat flora during penicillin therapy than dur ing cefprozil treatment. No difference in the incidence of adverse eve nts probably related or of unknown relationship to the study drugs was observed in the two treatment groups (5.2% of those treated with cefp rozil and 6.0% of those treated with penicillin). Cefprozil can be con sidered a safe and reliable drug for the treatment of streptococcal ph aryngitis in children.