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[Treatment of streptococcal tonsillo-pharyngitis in paediatric patients: short-course therapy with cefaclor]
S. Esposito1, S. Noviello, F. Ianniello
1Clinica Malattie Infettive e Clinica ORL, Seconda Universita degli Studi di Napoli, Napoli, Italy.
Insights
Short-course cefaclor treatment for streptococcal pharyngotonsillitis achieved high cure rates, comparable to 10-day regimens. This offers a potentially more compliant alternative for treating strep throat in children.
Area of Science:
- Pediatric Infectious Diseases
- Pharmacology and Therapeutics
Background:
- Short-course antibiotic regimens for streptococcal pharyngotonsillitis show promise for improved patient compliance.
- Oral cephalosporins and macrolides have demonstrated comparable efficacy to traditional 10-day treatments.
- Cefaclor has not been previously evaluated for short-course therapy in this indication.
Purpose of the Study:
- To investigate the efficacy and safety of a 5-day course of cefaclor compared to a 10-day course for treating streptococcal pharyngotonsillitis.
- To assess bacteriologic and clinical cure rates in children receiving different durations of cefaclor therapy.
- To evaluate patient compliance with short-course versus conventional-duration cefaclor treatment.
Main Methods:
- A randomized controlled trial involving 138 pediatric patients with confirmed *Streptococcus pyogenes* pharyngotonsillitis.
- Patients were assigned to receive cefaclor (25 mg/kg twice daily) for either 5 days (n=70) or 10 days (n=68).
- Clinical and bacteriologic assessments were performed post-treatment and during follow-up (20-30 days), with carriers excluded from final analysis.
Main Results:
- Clinical cure rates were high and similar in both groups: 92.8% for the 5-day course and 92.6% for the 10-day course.
- Bacteriologic eradication rates were also comparable: 92.8% and 92.6% for the 5-day and 10-day groups, respectively.
- The study population comprised children screened from a larger cohort to exclude carriers, ensuring evaluation of active infections.
Conclusions:
- A 5-day short-course therapy with cefaclor is an effective alternative for treating streptococcal pharyngotonsillitis.
- Short-course cefaclor treatment demonstrates efficacy comparable to the conventional 10-day regimen.
- This shorter treatment duration holds potential for enhanced patient compliance in pediatric populations.
Abstract:
Short-course treatments of streptococcal pharyngotonsillitis with oral cephalosporins and macrolides have resulted in a similar bacteriologic and clinical cure rate and in better compliance compared to the conventional 10-day course. Cefaclor has never been investigated for this purpose. 138 patients out of 420 recruited patients had a positive culture for S. pyogenes and were randomly assigned to receive cefaclor (25 mg/kg/bid) for a 5- (70 pts) or 10-day (68 pts) course. Patients were assessed clinically and bacteriologically 2-3 days after completing the course and followed up after 20-30 days. All 420 recruited patients belonged to a population of 2,800 children who had been previously screened for a streptococcal carrier state to exclude carriers from final evaluation. Clinical cure and bacteriological eradication was recorded in 92.8% and 92.6% of patients in groups A and B respectively. Therefore, short-course therapy with cefaclor may offer an effective alternative treatment to conventional regimens, with potential for better compliance.