5-day cefixime therapy for bacterial pharyngitis and/or tonsillitis: comparison with 10-day penicillin V therapy. Cefixime Study Group
D Adam1, U Hostalek, K Tröster
1Kinderklinik, Dr. von Haunerschen Kinderspital der Universität, München, Germany.
Insights
Cefixime and penicillin V showed similar efficacy in treating pediatric pharyngitis and tonsillitis. Both antibiotics demonstrated high cure rates and comparable safety profiles in this randomized controlled trial.
Area of Science:
- Pediatric Infectious Diseases
- Pharmacology
- Microbiology
Background:
- Pharyngitis and tonsillitis are common childhood infections.
- Antibiotic selection is crucial for effective treatment and preventing complications.
Purpose of the Study:
- To compare the clinical efficacy and safety of cefixime and penicillin V in children with pharyngitis/tonsillitis.
- To evaluate pathogen eradication rates and late relapses for both treatments.
Main Methods:
- A randomized, controlled, multicenter study involving 160 children.
- Treatment groups received either cefixime (8 mg/kg/day for 5 days) or penicillin V (20,000 IU/kg/day for 10 days).
- Clinical outcomes, pathogen elimination, and adverse events were assessed.
Main Results:
- Cefixime achieved an 86.7% cure rate, while penicillin V achieved 90.8%.
- Pathogen elimination rates were 82.6% for cefixime and 88.2% for penicillin V.
- Both treatments exhibited similar low rates of relapse and mild-to-moderate adverse events.
Conclusions:
- Cefixime is a viable alternative to penicillin V for treating pediatric pharyngitis and tonsillitis.
- Both antibiotics demonstrate comparable efficacy and safety in this pediatric population.
- Further research could explore long-term outcomes and resistance patterns.
Abstract:
In an open, controlled, randomized multicenter study, 160 children suffering from pharyngitis and/or tonsillitis were treated with either 8 mg cefixime/kg body weight once daily for 5 days or 20,000 I.U. penicillin V/kg body weight t.i.d. for 10 days. One hundred fifty-one children were evaluable for clinical efficacy. In the cefixime group, 65 (86.7%) children were cured, seven (9.3%) were significantly improved, one (1.3%) relapsed and in two (2.7%) therapy failed. Of the patients treated with penicillin V, 69 (90.8%) were cured, five (6.6%) improved, one (1.3%) relapsed and in one (1.3%) therapy failed. Elimination of initial pathogens occurred in 57 (82.6%) patients treated with cefixime and in 60 (88.2%) treated with penicillin V. At 3 to 4 weeks after the end of treatment, six relapses were seen in the cefixime group and eight in the penicillin V group. Mild-to-moderate adverse events that were possible related to the medication were seen in four children treated with cefixime and in five treated with penicillin V.
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