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Clarithromycin suspension vs penicillin V suspension in children with streptococcal pharyngitis

J McCarty1, J A Hedrick, W M Gooch

  • 1Valley Children's Hospital, Madera, California 93638, USA.

Advances in Therapy
|August 1, 2000
PubMed

Insights

Clarithromycin, an antibiotic, effectively treated streptococcal pharyngitis in children, showing superior eradication of group A beta-hemolytic streptococcus (GABHS) compared to penicillin V. A 5-day clarithromycin course proved more effective than 10-day penicillin.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Pharmacology

Background:

  • Clarithromycin exhibits potent in vitro activity against group A beta-hemolytic streptococcus (GABHS).
  • Its favorable pharmacokinetic profile suggests suitability for treating streptococcal pharyngitis.
  • Penicillin V is a standard treatment for GABHS infections.

Purpose of the Study:

  • To compare the safety and efficacy of clarithromycin and penicillin V in treating streptococcal pharyngitis in children.
  • To evaluate GABHS eradication rates between the two antibiotic regimens.

Main Methods:

  • A randomized, investigator-blind study compared 5-day clarithromycin suspension to 10-day penicillin V suspension in children aged 6 months to 12 years.
  • Clinical assessments and throat cultures were performed before, during, and after therapy.
  • Efficacy endpoints included clinical success and GABHS eradication rates.

Main Results:

  • Clarithromycin and penicillin V demonstrated comparable clinical success rates (97% vs. 94% post-treatment; 81% vs. 82% follow-up).
  • Clarithromycin achieved a significantly higher GABHS eradication rate (94% vs. 78%, P < .001).
  • Both treatments were well-tolerated with mild gastrointestinal complaints; no resistance emerged.

Conclusions:

  • A 5-day course of clarithromycin is superior to a 10-day course of penicillin V for eradicating Streptococcus pyogenes.
  • Clarithromycin offers an effective and well-tolerated alternative for pediatric streptococcal pharyngitis treatment.

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