Short-course antibiotic treatment of 4782 culture-proven cases of group A streptococcal tonsillopharyngitis and incidence of poststreptococcal sequelae

A large-scale study with a 1-year follow-up was performed to compare 10 day s of penicillin V with a short-course treatment (5 days) of other oral anti biotics in the treatment of group A beta-hemolytic streptococcus (GABHS) to nsillopharyngitis, to evaluate the efficacy and the incidence of poststrept ococcal sequelae. The clinical response rates after completion of therapy w ere 94.5% in the 5-day group and 93.4% in the penicillin group (P < .001, e quivalence test). The GABHS eradication rates were 83.3% in the 5-day group and 84.4% in the penicillin group (P = .022, equivalence test). Poststrept ococcal sequelae were rare (5 patients) and did not occur in the context of this study. The efficacy of 5-day antibiotic regimens was equivalent to 10 days of penicillin V, but resolution of clinical symptoms was faster in th e 5-day group (P < .001, Fisher's exact test). Recurrent tonsillopharyngiti s occurs more frequently after treatment with penicillin (P = .03, Fisher's exact test).