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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
dc.creator | Syrogiannopoulos, G. A. | en |
dc.creator | Bozdogan, B. | en |
dc.creator | Grivea, I. N. | en |
dc.creator | Ednie, L. M. | en |
dc.creator | Kritikou, D. I. | en |
dc.creator | Katopodis, G. D. | en |
dc.creator | Beratis, N. G. | en |
dc.creator | Appelbaum, P. C. | en |
dc.date.accessioned | 2015-11-23T10:49:14Z | |
dc.date.available | 2015-11-23T10:49:14Z | |
dc.date.issued | 2004 | |
dc.identifier | 10.1097/01.inf.0000138080.74674.a2 | |
dc.identifier.issn | 8913668 | |
dc.identifier.uri | http://hdl.handle.net/11615/33506 | |
dc.description.abstract | 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. | en |
dc.source.uri | http://www.scopus.com/inward/record.url?eid=2-s2.0-6344293907&partnerID=40&md5=aee2296d4cd265ca9e17ad99edca0248 | |
dc.subject | Amoxicillin/clavulanate | en |
dc.subject | Clarithromycin | en |
dc.subject | Group A streptococci | en |
dc.subject | Penicillin V | en |
dc.subject | Tonsillopharyngitis | en |
dc.subject | amoxicillin plus clavulanic acid | en |
dc.subject | adolescent | en |
dc.subject | antibiotic resistance | en |
dc.subject | antibiotic sensitivity | en |
dc.subject | article | en |
dc.subject | bacterium isolate | en |
dc.subject | child | en |
dc.subject | clinical trial | en |
dc.subject | controlled clinical trial | en |
dc.subject | controlled study | en |
dc.subject | dose response | en |
dc.subject | drug efficacy | en |
dc.subject | drug tolerability | en |
dc.subject | female | en |
dc.subject | follow up | en |
dc.subject | human | en |
dc.subject | major clinical study | en |
dc.subject | male | en |
dc.subject | multicenter study | en |
dc.subject | pharyngitis | en |
dc.subject | priority journal | en |
dc.subject | randomized controlled trial | en |
dc.subject | Streptococcus group A | en |
dc.subject | Streptococcus pyogenes | en |
dc.subject | tonsillitis | en |
dc.subject | treatment outcome | en |
dc.subject | acute disease | en |
dc.subject | comparative study | en |
dc.subject | drug administration | en |
dc.subject | drug effect | en |
dc.subject | hospitalization | en |
dc.subject | isolation and purification | en |
dc.subject | microbiology | en |
dc.subject | preschool child | en |
dc.subject | probability | en |
dc.subject | reference value | en |
dc.subject | risk assessment | en |
dc.subject | Streptococcus infection | en |
dc.subject | Amoxicillin-Potassium Clavulanate Combination | en |
dc.subject | Child, Preschool | en |
dc.subject | Dose-Response Relationship, Drug | en |
dc.subject | Drug Administration Schedule | en |
dc.subject | Follow-Up Studies | en |
dc.subject | Humans | en |
dc.subject | Reference Values | en |
dc.subject | Severity of Illness Index | en |
dc.subject | Streptococcal Infections | en |
dc.title | Two dosages of clarithromycin for five days, amoxicillin/clavulanate for five days or penicillin V for ten days in acute group A streptococcal tonsillopharyngitis | en |
dc.type | journalArticle | en |
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