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. 1993 Aug;37(8):1620–1623. doi: 10.1128/aac.37.8.1620

Cefprozil versus penicillin V in treatment of streptococcal tonsillopharyngitis.

D Milatovic 1, D Adam 1, H Hamilton 1, E Materman 1
PMCID: PMC188030  PMID: 8215273

Abstract

In a randomized multicenter study, the efficacy and safety of cefprozil were compared with those of penicillin in the treatment of group A streptococcal tonsillopharyngitis in children. Of the 409 patients enrolled, 323 were evaluable for their clinical and bacteriological responses; of these 323 children, 172 received cefprozil and 151 received penicillin V. The clinical responses in patients treated with cefprozil were significantly better than those in patients who received penicillin (95.3 versus 88.1%; P = 0.023). Eradication of the original serotype of group A streptococci was achieved in 91.3% of patients treated with cefprozil and 87.4% of patients treated with penicillin, the difference not being statistically significant (P = 0.125). However, there were significantly more symptomatic patients among the bacteriological failures in the penicillin group (68.4%) than in the cefprozil group (26.7%). beta-Lactamase-producing Staphylococcus aureus was more frequently isolated from the throat flora during penicillin therapy than during cefprozil treatment. No difference in the incidence of adverse events probably related or of unknown relationship to the study drugs was observed in the two treatment groups (5.2% of those treated with cefprozil and 6.0% of those treated with penicillin). Cefprozil can be considered a safe and reliable drug for the treatment of streptococcal pharyngitis in children.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Braveny I. Fortschritte beim Nachweis beta-hämolytischer Streptokokken. Dtsch Med Wochenschr. 1971 Feb 26;96(9):396–397. [PubMed] [Google Scholar]
  2. Brook I. The role of beta-lactamase-producing bacteria in the persistence of streptococcal tonsillar infection. Rev Infect Dis. 1984 Sep-Oct;6(5):601–607. doi: 10.1093/clinids/6.5.601. [DOI] [PubMed] [Google Scholar]
  3. Chin N. X., Neu H. C. Comparative antibacterial activity of a new oral cephalosporin, BMY-28100. Antimicrob Agents Chemother. 1987 Mar;31(3):480–483. doi: 10.1128/aac.31.3.480. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Christenson J. C., Swenson E., Gooch W. M., 3rd, Herrod J. N. Comparative efficacy and safety of cefprozil (BMY-28100) and cefaclor in the treatment of acute group A beta-hemolytic streptococcal pharyngitis. Antimicrob Agents Chemother. 1991 Jun;35(6):1127–1130. doi: 10.1128/aac.35.6.1127. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Disney F. A., Breese B. B., Francis A. B., Green J. L., Talpey W. B. The use of cefaclor in the treatment of beta-haemolytic streptococcal throat infections in children. Postgrad Med J. 1979;55 (Suppl 4):50–52. [PubMed] [Google Scholar]
  6. Eliopoulos G. M., Reiszner E., Wennersten C., Moellering R. C., Jr In vitro activity of BMY-28100, a new oral cephalosporin. Antimicrob Agents Chemother. 1987 Apr;31(4):653–656. doi: 10.1128/aac.31.4.653. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Gastanaduy A. S., Kaplan E. L., Huwe B. B., McKay C., Wannamaker L. W. Failure of penicillin to eradicate group A streptococci during an outbreak of pharyngitis. Lancet. 1980 Sep 6;2(8193):498–502. doi: 10.1016/s0140-6736(80)91832-2. [DOI] [PubMed] [Google Scholar]
  8. Gau D. W., Horn R. F., Solomon R. M., Johnson P., Leigh D. A. Streptococcal tonsillitis in general practice. A comparison of cephalexin and penicillin therapy. Practitioner. 1972 Feb;208(244):276–281. [PubMed] [Google Scholar]
  9. Gerber M. A., Randolph M. F., Chanatry J., Wright L. L., Anderson L. R., Kaplan E. L. Once daily therapy for streptococcal pharyngitis with cefadroxil. J Pediatr. 1986 Sep;109(3):531–537. doi: 10.1016/s0022-3476(86)80139-1. [DOI] [PubMed] [Google Scholar]
  10. Ginsburg C. M., McCracken G. H., Jr, Crow S. D., Steinberg J. B., Cope F. A controlled comparative study of penicillin V and cefadroxil therapy of group A streptococcal tonsillopharyngitis. J Int Med Res. 1980;8(Suppl 1):82–86. [PubMed] [Google Scholar]
  11. Gooch W. M., 3rd, Swenson E., Higbee M. D., Cocchetto D. M., Evans E. C. Cefuroxime axetil and penicillin V compared in the treatment of group A beta-hemolytic streptococcal pharyngitis. Clin Ther. 1987;9(6):670–677. [PubMed] [Google Scholar]
  12. KUNDSIN R. B., MILLER J. M. SIGNIFICANCE OF THE STAPHYLOCOCCUS AUREUS CARRIER STATE IN THE TREATMENT OF DISEASE DUE TO GROUP A STREPTOCOCCI. N Engl J Med. 1964 Dec 31;271:1395–1397. doi: 10.1056/NEJM196412312712705. [DOI] [PubMed] [Google Scholar]
  13. Kim K. S., Kaplan E. L. Association of penicillin tolerance with failure to eradicate group A streptococci from patients with pharyngitis. J Pediatr. 1985 Nov;107(5):681–684. doi: 10.1016/s0022-3476(85)80392-9. [DOI] [PubMed] [Google Scholar]
  14. Liebermeister K., Braveny I. Ein Nährsubstrat zur Isolierung von beta-hämolytischen Streptokokken. Z Med Mikrobiol Immunol. 1971;156(2):149–153. [PubMed] [Google Scholar]
  15. Milatovic D., Knauer J. Cefadroxil versus penicillin in the treatment of streptococcal tonsillopharyngitis. Eur J Clin Microbiol Infect Dis. 1989 Apr;8(4):282–288. doi: 10.1007/BF01963451. [DOI] [PubMed] [Google Scholar]
  16. Milatović D. Comparison of five selective media for beta-haemolytic streptococci. J Clin Pathol. 1981 May;34(5):556–558. doi: 10.1136/jcp.34.5.556. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Pichichero M. E., Disney F. A., Aronovitz G. H., Talpey W. B., Green J. L., Francis A. B. Randomized, single-blind evaluation of cefadroxil and phenoxymethyl penicillin in the treatment of streptococcal pharyngitis. Antimicrob Agents Chemother. 1987 Jun;31(6):903–906. doi: 10.1128/aac.31.6.903. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Pichichero M. E., Margolis P. A. A comparison of cephalosporins and penicillins in the treatment of group A beta-hemolytic streptococcal pharyngitis: a meta-analysis supporting the concept of microbial copathogenicity. Pediatr Infect Dis J. 1991 Apr;10(4):275–281. doi: 10.1097/00006454-199104000-00002. [DOI] [PubMed] [Google Scholar]
  19. Schassan H. H. Eine neue Methode zur Prüfung der beta-Laktamaseproduktion resistenter Enterobacteriaceaestämme. Zentralbl Bakteriol Orig A. 1978;242(3):347–354. [PubMed] [Google Scholar]

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