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Azithromycin versus cefaclor in the treatment of pediatric patients with acute group A beta-hemolytic streptococcal
J Cremer1, C Wallrauch, D Milatovic
1Institute of Medical Microbiology, Technical University, Munich, Germany.
Insights
This study compared azithromycin and cefaclor for treating pediatric streptococcal tonsillopharyngitis. Both antibiotics showed similar clinical success rates, but cefaclor achieved higher bacterial eradication in children.
Area of Science:
- Pediatric infectious diseases
- Microbiology
- Pharmacology
Background:
- Group A beta-hemolytic streptococcal tonsillopharyngitis is common in children.
- Antibiotic therapy is crucial for treating streptococcal pharyngitis.
- Evaluating different antibiotic regimens is essential for optimizing treatment outcomes.
Purpose of the Study:
- To compare the efficacy and safety of azithromycin versus cefaclor in treating pediatric group A streptococcal tonsillopharyngitis.
- To assess clinical success and bacterial eradication rates for both antibiotic regimens.
Main Methods:
- An open, comparative, multicenter study involving 122 children aged 1-12 years.
- Patients were randomly assigned to receive either azithromycin (10 mg/kg once daily for 3 days) or cefaclor (30 mg/kg divided into 3 daily doses for 10 days).
- Clinical outcomes and bacterial eradication were assessed after treatment.
Main Results:
- Overall clinical success rates were identical for both groups (86.3%).
- Bacterial eradication rates were lower with azithromycin compared to cefaclor.
- Both azithromycin and cefaclor were well-tolerated, with mild to moderate gastrointestinal side effects reported.
Conclusions:
- Azithromycin and cefaclor demonstrate comparable clinical efficacy in treating pediatric streptococcal tonsillopharyngitis.
- Cefaclor showed superior bacterial eradication rates compared to azithromycin.
- Potential reasons for lower eradication with azithromycin include antibiotic resistance, pre-disease carriage, or dosage considerations.
Abstract:
An open, comparative multicenter study was performed to evaluate the efficacy and safety of azithromycin (10 mg/kg) given once daily for three days in comparison with cefaclor (30 mg/kg) divided into three daily doses and given for a period of ten days. One hundred and twenty-two children aged 1-12 years with clinical symptoms of group A beta-hemolytic streptococcal tonsillopharyngitis and a positive throat culture were randomly allocated to the treatment groups. Overall, the clinical success (cure or improvement) of both regimens was identical in the evaluable patients (86.3%, 44 of 51 patients in either treatment group). In contrast, bacterial eradication after completion of treatment was lower with azithromycin than with cefaclor. Possible reasons for this discrepancy between clinical success and eradication rates could be antibiotic resistance, pre-disease carriage or insufficient dosage. Both agents were well tolerated; only mild or moderate side effects most frequently involving the gastrointestinal tract, were recorded in either therapy group.