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Symptomatic relapse of group A beta-hemolytic streptococcal tonsillopharyngitis in children

Janet R Casey1, Michael E Pichichero

  • 1University of Rochester School of Medicine, Elmwood Pediatric Group, Rochester, New York, USA. jrcasey@rochester.rr.com

Clinical Pediatrics
|May 4, 2007
PubMed

Insights

Antibiotic choice impacts relapse rates for group A streptococcal tonsillopharyngitis in children. Penicillin and amoxicillin showed higher failure rates compared to cephalosporins, necessitating careful drug selection for effective treatment.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Pharmacology

Background:

  • Group A beta-hemolytic streptococcal tonsillopharyngitis is a common childhood infection.
  • Antibiotic therapy is the standard treatment, but treatment failures and relapses can occur.

Purpose of the Study:

  • To evaluate the frequency of symptomatic relapses after different antibiotic treatments for group A streptococcal tonsillopharyngitis in pediatric patients.
  • To compare the effectiveness of various antibiotic classes in preventing relapses.

Main Methods:

  • A study involving 1080 pediatric patients diagnosed with group A beta-hemolytic streptococcal tonsillopharyngitis.
  • Analysis of symptomatic relapse rates within 5 days of completing antibiotic therapy.
  • Comparison of relapse frequencies across different antibiotic regimens.

Main Results:

  • The rank-order frequency of treatment failures was highest for penicillin, followed by amoxicillin, then first-generation cephalosporins, and lastly beta-lactamase stable cephalosporins and amoxicillin-clavulanate (P = .005).
  • Retreatment of symptomatic failures led to a higher rate of subsequent relapses with penicillin compared to cephalosporins (P = .02).

Conclusions:

  • The choice of antibiotic significantly influences the rate of symptomatic failures and relapses in pediatric group A streptococcal tonsillopharyngitis.
  • Penicillin and amoxicillin appear less effective in preventing relapses compared to certain cephalosporins.
  • Clinicians must consider these differences when selecting antibiotic therapy to minimize treatment failures.

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