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 Vol. 20 No. 2, August 2008
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AAP Grand Rounds 20:15-16 (2008)
© 2008 American Academy of Pediatrics

INFECTIOUS DISEASES

Antibiotic Therapy for Streptococcal Pharyngitis Revisited

Source: Lennon DR, Farrell E, Martin DR, et al. Once-daily amoxicillin versus twice-daily penicillin V in group A β-haemolytic streptococcal pharyngitis. Arch Dis Child. 2008;93(6):474–478; doi:10.1136/adc.2006.113506[Abstract/Free Full Text]

The first 20% of the full text of this article appears below.


PICO

Question: Among school-age children with group A β-hemolytic streptococcal pharyngitis, does once-daily amoxicillin eradicate GAβHS as well as twice-daily penicillin?

Question type: Therapy

Study design: Prospective, randomized, non-blinded trial

 

Investigators from New Zealand enrolled children 5–12 years of age in a prospective, randomized (1:1), nonblinded study to determine if oral once-daily amoxicillin (1500 mg if >30 kg, 750 mg if ≤30 kg; n=177) was noninferior to oral twice-daily penicillin V (500 mg if >30 kg, 250 mg if ≤ 30 kg; n=176) for treatment of group A β-hemolytic streptococcal (GAβHS) pharyngitis. Both drugs were given for 10 days.

Children were enrolled between May 1996 and November 1998 if they presented with a sore throat and signs and symptoms suggestive of acute pharyngitis at a school clinic and had a throat culture positive for GAβHS. Noninferiority was defined as the upper confidence limit (CL) of a less than 10% difference in treatment effect between the two arms.

Exclusion criteria included receipt of antibiotics in the previous 72 hours; history of acute rheumatic fever (ARF), cardiac or kidney disease; a rash suggestive of scarlet fever . . . [Full Text of this Article]

Mobeen H. Rathore, MD, FAAP1 and Leslie L. Barton, MD, FAAP2
1 Pediatric Infectious Diseases and Immunology, University of Florida, Jacksonville, FL
2 University of Arizona School of Medicine, Tucson, AZ