5-DAY CEFDINIR TREATMENT FOR STREPTOCOCCAL PHARYNGITIS

A multicenter, randomized, controlled, investigator-blind study was pe rformed to evaluate the safety and efficacy of oral cefdinir versus or al penicillin V for the treatment of pharyngitis due to group A beta-h emolytic streptococci (GABHS). Patients 13 years of age and older were randomized to receive either oral cefdinir (300 mg twice a day) for 5 days followed by placebo for 5 days or oral penicillin V (250 mg four times a day) for 10 days. Throat cultures were obtained, and signs an d symptoms of pharyngitis were recorded at study admission and follow- up visits on study days 11 to 15, 16 to 20, and 25 to 31. Patients kep t a diary to record medication intake and their assessment of throat p ain at admission and at each day of study treatment. Five hundred fift y-eight patients were enrolled, of whom 432 (77.4%) were clinically an d microbiologically evaluable. The GABHS eradication rates 5 to 10 day s after completion of therapy were 193 of 218 (88.5%) in the cefdinir group and 176 of 214 (82.2%) in the penicillin group (P = 0.053). Clin ical cure rates were 89.0 and 84.6%, respectively (P = 0.80). By the t ime of the long-term follow-up visit, 2 to 3 weeks after completion of treatment, 156 of 191 (81.7%) of the assessable cefdinir patients and 152 of 195 (77.9%) of the penicillin patients remained free of GABHS. Both treatments were well tolerated, with adverse reaction rates of 1 8.3% in the cefdinir study arm and 15.0% in the penicillin study arm ( P = 0.278). Five-day treatment with cefdinir is safe and effective the rapy for GABHS pharyngitis. Based on its twice-a-day dosage and shorte r course of therapy, leading to potentially greater patient compliance , cefdinir may be considered for use in the treatment of pharyngitis c aused by GABHS.