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Cefadroxil versus penicillin in the treatment of streptococcal tonsillopharyngitis

D Milatovic1, J Knauer

  • 1Department of Hygiene, Technical University, 8000 Munich, FRG.

European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology
|April 1, 1989
PubMed

Insights

Cefadroxil demonstrated superior efficacy over phenoxymethyl-penicillin in treating acute tonsillopharyngitis caused by group A streptococci in children. Cefadroxil achieved significantly lower microbiological failure rates, indicating better treatment outcomes.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Pharmacology

Background:

  • Acute tonsillopharyngitis is a common childhood illness.
  • Group A streptococci are a primary bacterial cause of acute tonsillopharyngitis.
  • Phenoxymethyl-penicillin has been a standard treatment, but resistance and efficacy concerns exist.

Purpose of the Study:

  • To compare the efficacy of cefadroxil and phenoxymethyl-penicillin in treating group A streptococcal tonsillopharyngitis.
  • To evaluate microbiological and clinical failure rates between the two antibiotic treatments.
  • To assess the impact of beta-lactamase producing staphylococci on treatment outcomes.

Main Methods:

  • A randomized multicenter study involving 300 children with suspected streptococcal tonsillopharyngitis.
  • Patients were treated with either phenoxymethyl-penicillin or cefadroxil.
  • Microbiological and clinical assessments were performed after ten days of therapy.

Main Results:

  • Cefadroxil showed a significantly lower microbiological failure rate (6.8%) compared to phenoxymethyl-penicillin (19%) (p<0.01).
  • Fewer patients treated with cefadroxil experienced clinical symptoms alongside microbiological failure.
  • The presence of beta-lactamase producing staphylococci was associated with higher failure rates in the penicillin group.

Conclusions:

  • Cefadroxil is clinically and bacteriologically superior to phenoxymethyl-penicillin for treating acute tonsillopharyngitis caused by group A streptococci.
  • Antibiotic choice should consider local flora, including beta-lactamase producing organisms.
  • Cefadroxil represents a more effective therapeutic option for this common pediatric infection.

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