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  • Επιστημονικές Δημοσιεύσεις Μελών ΠΘ (ΕΔΠΘ)
  • Δημοσιεύσεις σε περιοδικά, συνέδρια, κεφάλαια βιβλίων κλπ.
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  • Επιστημονικές Δημοσιεύσεις Μελών ΠΘ (ΕΔΠΘ)
  • Δημοσιεύσεις σε περιοδικά, συνέδρια, κεφάλαια βιβλίων κλπ.
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Two dosages of clarithromycin for five days, amoxicillin/clavulanate for five days or penicillin V for ten days in acute group A streptococcal tonsillopharyngitis

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Autor
Syrogiannopoulos, G. A.; Bozdogan, B.; Grivea, I. N.; Ednie, L. M.; Kritikou, D. I.; Katopodis, G. D.; Beratis, N. G.; Appelbaum, P. C.
Datum
2004
DOI
10.1097/01.inf.0000138080.74674.a2
Schlagwort
Amoxicillin/clavulanate
Clarithromycin
Group A streptococci
Penicillin V
Tonsillopharyngitis
amoxicillin plus clavulanic acid
adolescent
antibiotic resistance
antibiotic sensitivity
article
bacterium isolate
child
clinical trial
controlled clinical trial
controlled study
dose response
drug efficacy
drug tolerability
female
follow up
human
major clinical study
male
multicenter study
pharyngitis
priority journal
randomized controlled trial
Streptococcus group A
Streptococcus pyogenes
tonsillitis
treatment outcome
acute disease
comparative study
drug administration
drug effect
hospitalization
isolation and purification
microbiology
preschool child
probability
reference value
risk assessment
Streptococcus infection
Amoxicillin-Potassium Clavulanate Combination
Child, Preschool
Dose-Response Relationship, Drug
Drug Administration Schedule
Follow-Up Studies
Humans
Reference Values
Severity of Illness Index
Streptococcal Infections
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Zusammenfassung
Background: Short course antimicrobial therapy is suggested for group A streptococcal tonsillopharyngitis. Methods: The bacteriologic and clinical efficacies of clarithromycin [30 or 15 mg/kg/day twice daily (b.i.d.)] or amoxicillin/clavulanate (43.8/6.2 mg/kg/day b.i.d.) for 5 days or penicillin V (30 mg/kg/day 3 times a day) for 10 days were compared. In a randomized, open label, parallel group, multicenter study, 626 children (2-16 years old) with tonsillopharyngitis were enrolled; 537 were evaluable for efficacy. Follow-up evaluations were performed at 4-8 and 21-28 days after therapy. Results: At enrollment, 26% of the Streptococcus pyogenes isolates were clarithromycin- nonsusceptible. All regimens had an apparently similar clinical efficacy. The long term S. pyogenes eradication rates were 102 of 123 (83%) with amoxicillin/clavulanate and 88 of 114 (77%) with penicillin V. In the 30- and 15-mg/kg/day clarithromycin groups, eradication occurred in 71 of 86 (83%) and 59 of 80 (74%) of the clarithromycin-susceptible isolates (P = 0.33), and in 4 of 28 (14%) and 5 of 26 (19%) of the clarithromycin-resistant isolates, respectively (clarithromycin-susceptible versus -resistant, P < 0.0001). Both clarithromycin dosages were well-tolerated. Conclusions: In group A streptococcal tonsillopharyngitis, 5 days of clarithromycin or amoxicillin/clavulanate treatment had clinical efficacy comparable with that of 10 days of penicillin V treatment; however, amoxicillin/clavulanate and penicillin V were bacteriologically more effective than clarithromycin because of its failure to eradicate the clarithromycin-resistant S. pyogenes isolates. The 5-day clarithromycin regimens are not recommended for treatment of streptococcal tonsillopharyngitis in areas where in vitro resistance of group A streptococci to clarithromycin is common.
URI
http://hdl.handle.net/11615/33506
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  • Δημοσιεύσεις σε περιοδικά, συνέδρια, κεφάλαια βιβλίων κλπ. [19735]

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