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Five day clarithromycin modified release versus 10 day penicillin V for group A streptococcal pharyngitis: a
Henri Portier1, Jamila Filipecki, Philippe Weber
1Dijon University Hospital, Hôpital du Bocage, Service des Maladies Infectieuses, 2 boulevard de Lattre de Tassigny, 21034, Dijon, France. henriporter@chu-dijon.fr
The Journal of Antimicrobial Chemotherapy
|January 30, 2002
Summary
Clarithromycin modified release (MR) offers a safe and effective 5-day treatment for group A beta-haemolytic streptococci (GABHS) pharyngitis. This antibiotic is comparable to penicillin V, demonstrating similar efficacy and tolerability in clinical trials.
Area of Science:
- Infectious Diseases
- Pharmacology
- Clinical Trials
Background:
- Pharyngitis caused by group A beta-haemolytic streptococci (GABHS) is a common bacterial infection.
- Penicillin V has been the standard treatment, but adherence can be challenging due to multiple daily doses.
Purpose of the Study:
- To compare the efficacy and tolerability of clarithromycin modified release (MR) with penicillin V for GABHS pharyngitis.
- To evaluate a shorter, once-daily dosing regimen of clarithromycin MR.
Main Methods:
- A multicentre, randomized, open-label Phase III trial involving 349 patients aged 12-40 years with confirmed GABHS pharyngitis.
- Patients received either clarithromycin MR 500 mg once daily for 5 days or penicillin V 590 mg three times daily for 10 days.
- Efficacy was assessed by clinical evaluation and bacteriological cure rates post-treatment.
Main Results:
- No statistically significant differences were observed in clinical cure rates (clarithromycin: 88.1%, penicillin: 92.4%) or eradication rates (clarithromycin: 82.8%, penicillin: 83.6%) in the intent-to-treat analysis.
- Per-protocol analysis showed similar high cure and eradication rates for both treatments.
- Adverse events were comparable between the clarithromycin MR and penicillin V groups, mostly mild to moderate.
Conclusions:
- Clarithromycin MR administered once daily for 5 days is a safe and effective alternative to penicillin V for treating GABHS pharyngitis.
- The simplified dosing regimen of clarithromycin MR may improve patient adherence compared to standard penicillin V therapy.