Spiramycin and erythromycin in the treatment of acute tonsillo-pharyngitis: a comparative study

A randomized study was carried out in 100 patients with acute tonsillo-pharyngitis to compare the effectiveness and tolerance of treatment with 500 mg spiramycin 3-times daily for 3 days and 500 mg erythromycin 3-times daily for 5 days. Details were recorded on entry of fever, sore throat, difficulty in swallowing, inflammation of the tonsils and/or pharynx, and oedema. Patients in the two groups were re-examined on Days 4 and 6, respectively. Throat swab cultures and blood determinations of haemoglobin, leucocytes and erythrocyte sedimentation rate were made before and after treatment. The results, analyzed in the 95 patients (48 on spiramycin, 47 on erythromycin) who attended for follow-up, indicated that whilst both antibiotics were effective, only 1 patient receiving spiramycin was classified as failing to respond to treatment compared with 8 of those receiving erythromycin. Moreover, significantly fewer patients on erythromycin had complete disappearance of all the signs and symptoms at the end of the treatment period. These findings were supported by the results of the bacteriological cultures. Both treatments reduced leucocyte levels in those patients with high counts initially, but there was no apparent effect on haemoglobin or erythrocyte sedimentation rate. Two patients on spiramycin complained of dry mouth. In the erythromycin group, 2 patients reported dizziness and 5 nausea.