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[5-day therapy of bacterial pharyngitis and tonsillitis with cefixime. Comparison with 10 day treatment with
D Adam1, U Hostalek, K Tröster
1Dr. von Haunersches Kinderspital, München.
Insights
A 5-day cefixime suspension was as effective as penicillin V for treating bacterial pharyngitis and tonsillitis in children. Both treatments demonstrated good clinical efficacy and safety profiles in this randomized study.
Area of Science:
- Pediatric Infectious Diseases
- Bacteriology
- Pharmacology
Background:
- Bacterial pharyngitis and tonsillitis are common childhood infections.
- Antibiotic therapy is crucial for managing these conditions.
- Optimizing treatment duration and efficacy is an ongoing clinical goal.
Purpose of the Study:
- To compare the clinical and microbiological efficacy of a 5-day cefixime suspension regimen with a 10-day penicillin V regimen in children with bacterial pharyngitis/tonsillitis.
- To assess the safety and tolerability of both antibiotic treatments.
Main Methods:
- An open, controlled, randomized multicenter study involving 160 children aged 1-12 years.
- Children received either cefixime suspension (8 mg/kg once daily for 5 days) or penicillin V suspension (20,000 IU/kg t.i.d. for 10 days).
- Clinical cure rates, microbiological eradication, and adverse events were evaluated.
Main Results:
- Clinical efficacy was high for both groups: 86.7% cure and 9.3% improvement with cefixime versus 90.8% cure and 6.6% improvement with penicillin V.
- Microbiological eradication rates were 82.6% for cefixime and 88.2% for penicillin V.
- Both treatments were well-tolerated, with mild to moderate adverse events reported in a small number of children.
Conclusions:
- A 5-day course of cefixime suspension is a safe and effective alternative to a 10-day course of penicillin V for treating bacterial pharyngitis and tonsillitis in children.
- Shorter antibiotic durations may improve treatment adherence and reduce potential side effects.
Abstract:
160 children aged 1 to 12 years with clinical diagnosis of bacterial pharyngitis and/or tonsillitis were treated either with cefixime ready-to-use-suspension or penicillin V in an open, controlled and randomized multicenter study. Before treatment a rapid antigen detection test was accomplished and throat swabs were taken. After randomization, the children were either treated for 5 days with 8 mg cefixime/kg bodyweight ready-to-use suspension once daily or with 20,000 I.U. penicillin V/kg bodyweight t.i.d. also administered as suspension. The data of 151 children could be evaluated for clinically efficacy. In the cefixime-group 86.7% of the children were cured and 9.3% significantly improved. After initial improvement, in one child (1.3%) a relapse occurred and in the two remaining children (2.7%) therapy failed. 90.8% of the patients treated with penicillin V were cured, 6.6% improved and in one child each a relapse was registered resp. therapy failed. Complete microbiological data were available in 137 patients. In the cefixime-group in 82.6% of the patients the pathogens were eradicated. The elimination rate in the penicillin-group was 88.2%. At the follow-up 3-4 weeks after end of treatment 6 relapses were seen in the cefixime-group, and 8 in the patients treated with penicillin. Both regimes were safe. Mild to moderate adverse events at least possibly related to the study medication were seen in only 4 children treated with cefixime and in 5 treated with penicillin. A 5 day treatment of bacterial pharyngitis and tonsillitis with cefixime was as effective as a ten day treatment with penicillin V.