CLINICAL COMPARISON OF CEFACLOR TWICE-DAILY VERSUS AMOXICILLIN-CLAVULANATE OR ERYTHROMYCIN 3 TIMES DAILY IN THE TREATMENT OF PATIENTS WITH STREPTOCOCCAL PHARYNGITIS

The present study was undertaken to compare the efficacy and safety of a new regimen of cefaclor (25 mg/kg BID) with amoxicillin-clavulanate and erythromycin TID at standard doses for the treatment of pediatric patients with acute pharyngotonsillitis (APT). A total of 673 childre n (age range, 2 to 12 years) with signs and symptoms of APT were enrol led; 245 of these children who had a positive throat culture for group A beta-hemolytic streptococci (GABHS) entered the study and were rand omly assigned to receive cefaclor 25 mg/kg BID, amoxicillin-clavulanat e 15 mg/kg TID, or erythromycin 15 mg/kg TID. A 10-day antibiotic cour se was prescribed for each patient. Clinical and bacteriologic respons es were assessed at the end of treatment (day 10) and at the follow-up visit (day 30), All GABHS strains isolated from throat cultures were tested for in vitro sensitivity to the antibiotics used in the study, Side effects (mainly nausea) were rare and mild in each group and did not require discontinuation of therapy. No GABHS strain was resistant to cefaclor or to amoxicillin-clavulanate: 37.9% of the strains were r esistant to erythromycin. The results indicated that cefaclor given BI D seems to be as effective as amoxicillin-clavulanate given TID (cure rate, 91.9% and 90.5%, respectively) and more effective than erythromy cin given TID (cure rate, 76.8%) for the treatment of patients with AP T. Erythromycin resistance among GABHS is an emerging problem in many geographic areas.