Comparison of cefdinir and penicillin V in the treatment of pediatric streptococcal tonsillopharyngitis

Background, Group A beta-hemolytic streptococcal (GABHS) tonsillopharyngiti s continues to be a prevalent pediatric infectious disease that requires pr ompt treatment for relief of symptoms and to prevent complications. Objective. To compare the efficacy/tolerability of cefdinir and penicillin V in the treatment of pediatric GABHS tonsillopharyngitis as demonstrated i n two clinical trials of similar design. Design. Multicenter, randomized, investigator-blinded trials. Patients. Children less than or equal to 12 years of age with sore throat, pharyngeal erythema and positive rapid streptococcal antigen test results. Intervention. In Study A patients took cefdinir 7 mg/kg twice daily or 14 m g/kg once daily or penicillin V 10 mg/kg 4 times daily (all regimens for 10 days). In Study B patients took cefdinir 7 mg/kg twice daily for 5 days or penicillin V 10 mg/kg 4 times daily for 10 days. Measurements, Clinical and microbiologic evaluations were conducted at mult iple times during and after therapy. Results. Of 1274 patients 1122 were evaluable (679 patients received cefdin ir; 443 received penicillin V), Clinical cure and microbiologic eradication rates were superior in the combined cefdinir treatment groups (94.9 and 92 .7%, respectively), whether given once or twice daily for 10 days or twice daily for 5 days, compared with the penicillin treatment group (88.5 and 70 .9%, respectively; P < 0.001 for both). Adverse event rates were comparable in the 2 groups. Conclusion. Cefdinir is a reliable and well-tolerated drug for the manageme nt of GABHS tonsillopharyngitis in children.