Cephalosporins are more effective than penicillin in streptococcal pharyngitis.
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to M Stillerman.
Explore the source record for details and available documents.
Ninety-three children from four pediatric practices, with clinical and bacteriologic evidence of acute Group A beta-hemolytic streptococcal pharyngitis (GABHS) randomly received cefuroxime axetil (60 cases) or phenoxymethyl penicillin (33 cases). Cefuroxime axetil was given twice daily (125 mg). Phenoxymethyl penicillin was given three times daily (250 mg). The treatment groups were similar. Throat cultures were routine 2 to 7 days after the start of therapy and 2 days and 14 days after the end of therapy. The bacterial cure rates were 85 percent (51/60) for cefuroxime axetil, and 88 percent (29/33) for phenoxymethyl penicillin treated patients. Clinical results were comparable in both treatment groups. It was concluded that cefuroxime axetil given twice daily is as effective as phenoxymethyl penicillin given three times daily in producing bacteriologic eradication and clinical symptomatic improvement in children with GABHS.
In previous studies, twice daily (bid) and four times daily (qid) administration of most antibiotics approved for group A streptococcus (GAS) pharyngitis therapy have been demonstrated to be equally effective. In this study, four investigators collaborated in a double-blind, randomized multicenter study assessing the efficacy of cephalexin given in doses of 1.0 g or 0.5 g daily on a bid or qid regimen for 10 to 14 days to 157 patients with GAS pharyngitis. The mean daily doses for patients on the bid and qid regimens were 30 mg/kg and 29 mg/kg, respectively. Pretreatment and two follow-up cultures, usually 2 to 6 and 12 to 16 days after the end of treatment, were taken on all patients. Failure, defined as recurrence of the original GAS M-precipitin and T-agglutination types on follow-up culture, occurred in 7.3 percent of 82 patients on the bid and 5.3 percent of 75 patients on the qid regimen. We conclude that cephalexin bid and qid regimens are equally effective, and that the bid regimen can be recommended for all antibiotics approved for GAS pharyngitis therapy.
An intraocular lens carrier for anterior and posterior chamber lenses has been developed. The device consists of a protective polypropylene envelope with an insertion leaf, which allows anterior chamber lenses to be inserted without iris or corneal touch and posterior chamber lenses to be guided into the ciliary sulcus or capsular bag with minimal or no haptic manipulation. +
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Clindamycin palmitate and potassium phenoxymethyl penicillin were evaluated in 103 children with upper respiratory illnesses and pharyngeal group A streptococci, from November 1970 to July 1971. The children were assigned randomly by weight to one of the antibiotic regimens given orally for 10 days. Clindamycin palmitate and potassium phenoxymethyl penicillin dosages were 75 and 125 mg, respectively, in 5 ml tid for children weighing less than 25 kg, and 150 and 250 mg, respectively, in 10 ml bid for children weighing 25 kg or more. Recurrences of the original streptococcal group A, M, and T types within 3 weeks after the end of treatment were classified as failures. The failure rates were: clindamycin palmitate, 10% (5 of 52), and potassium phenoxymethyl penicillin, 18% (9 of 51). Possible drug-related rashes were observed in 8 of 52 clindamycin palmitate-treated patients. The geometric mean minimal inhibitory concentrations of clindamycin and penicillin against 103 isolates of group A streptococci were 0.033 and 0.007 mug/ml, respectively. The serum concentrations about 70 min after ingesting 150 mg of clindamycin palmitate averaged 3.8 mug/ml and after 250 mg of potassium phenoxymethyl penicillin averaged 0.9 mug/ml. Clindamycin palmitate was as effective as potassium phenoxymethyl penicillin in eradicating group A streptococci from the pharynx in tid and bid regimens. Nevertheless, because of its rash-producing tendency in some patients and higher cost, clindamycin palmitate should not be preferred to penicillin for treatment of streptococcal sore throat in the non-penicillin-allergic patient.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The purpose of the study was to compare the efficacy of cefaclor with that of penicillin V potassium (penicillin) in patients with Group A streptococcal pharyngitis. One hundred four children with pharyngitis and serologically confirmed Group A streptococci were randomly treated with cefaclor or penicillin using a mean dosage of 20 mg/kg/day for 10 days. The difference in failure rates (14% for 51 cefaclor- and 30% for 53 penicillin V-treated patients) was statistically significant (P = 0.04). In four earlier similar studies I found that cephaloglycin, cephalexin (two studies) and cefatrizine were consistently but not significantly more effective than penicillin therapy. When the data from the five studies are combined the difference between the failure rates (11% for 263 oral cephalosporin- and 23% for 230 penicillin-treated patients) becomes highly significant (P less than 0.001). The 95% confidence interval for the odds for treatment failure are 2.4 times greater for patients receiving penicillin than for those receiving one of the oral cephalosporins. On the basis of these data I conclude that the oral cephalosporins appear to be more effective than penicillin for therapy of Group A streptococcal pharyngitis.
Explore the source record for details and available documents.
Explore the source record for details and available documents.