Treatment of anginose infectious mononucleosis with metronidazole. A controlled clinical and laboratory study

Metronidazole (600-1 200 mg daily) and phenoxymethyl penicillin (1.6 g daily) were administered to 21 patients with anginose type of infectious mononucleosis. A control group with 19 other patients received only phenoxymethyl penicillin in the same dosage. The patients were randomly allocated to metronidazole treatment and were stratified into 2 further groups according to the duration of tonsillitis (less than or equal to 5 and > days, respectively) before instituted therapy. Changes in the state of the tonsillitis, body temperature reaction and acute phase reactants (alfa1-antitrypsin, antichymotrypsin, C-reactive protein, haptoglobin and orosomucoid) were parameters for evaluation of the effect. Metronidazole treatment resulted in a more rapid regression of tonsillitis note on the 4th day in both treated groups and a faster defervescence noted on the 3rd day compared to controls. The effect was most pronounced in patients with a duration of tonsillitis for > 5 days at admission. At 2 weeks after start of treatment a more rapid normalization of acute phase reactants was seen in the metronidazole groups. Especially in patients with tonsillitis for > 5 days before treatment the decrease of the C-reactive protein level was rapid during the 1st week.