Penicillin V four times daily for five days versus three times daily for 10 days in patients with pharyngotonsillitis caused by group A streptococci: randomized controlled, open label, non-inferiority study

2020 ◽  
Vol 58 (5) ◽  
pp. 851-852
Author(s):  
Alisa Fujihashi ◽  
Jerrilyn Jones
Keyword(s):  
Group A Streptococci ◽  
Open Label ◽  
Randomized Controlled ◽  
Penicillin V ◽  
Group A

scholarly journals Penicillin V four times daily for five days versus three times daily for 10 days in patients with pharyngotonsillitis caused by group A streptococci: randomised controlled, open label, non-inferiority study

BMJ ◽  
2019 ◽  
pp. l5337 ◽  
Author(s):  
Gunilla Skoog Ståhlgren ◽  
Mia Tyrstrup ◽  
Charlotta Edlund ◽  
Christian G Giske ◽  
Sigvard Mölstad ◽  
...  
Keyword(s):  
Adverse Events ◽  
Clinical Cure ◽  
Day Treatment ◽  
Group A Streptococci ◽  
Open Label ◽  
Link Type ◽  
Penicillin V ◽  
Bacteriological Eradication ◽  
Group A ◽  
Randomised Controlled

Abstract Objective To determine whether total exposure to penicillin V can be reduced while maintaining adequate clinical efficacy when treating pharyngotonsillitis caused by group A streptococci. Design Open label, randomised controlled non-inferiority study. Setting 17 primary healthcare centres in Sweden between September 2015 and February 2018. Participants Patients aged 6 years and over with pharyngotonsillitis caused by group A streptococci and three or four Centor criteria (fever ≥38.5°C, tender lymph nodes, coatings of the tonsils, and absence of cough). Interventions Penicillin V 800 mg four times daily for five days (total 16 g) compared with the current recommended dose of 1000 mg three times daily for 10 days (total 30 g). Main outcome measures Primary outcome was clinical cure five to seven days after the end of antibiotic treatment. The non-inferiority margin was prespecified to 10 percentage points. Secondary outcomes were bacteriological eradication, time to relief of symptoms, frequency of relapses, complications and new tonsillitis, and patterns of adverse events. Results Patients (n=433) were randomly allocated to the five day (n=215) or 10 day (n=218) regimen. Clinical cure in the per protocol population was 89.6% (n=181/202) in the five day group and 93.3% (n=182/195) in the 10 day group (95% confidence interval −9.7 to 2.2). Bacteriological eradication was 80.4% (n=156/194) in the five day group and 90.7% (n=165/182) in the 10 day group. Eight and seven patients had relapses, no patients and four patients had complications, and six and 13 patients had new tonsillitis in the five day and 10 day groups, respectively. Time to relief of symptoms was shorter in the five day group. Adverse events were mainly diarrhoea, nausea, and vulvovaginal disorders; the 10 day group had higher incidence and longer duration of adverse events. Conclusions Penicillin V four times daily for five days was non-inferior in clinical outcome to penicillin V three times daily for 10 days in patients with pharyngotonsillitis caused by group A streptococci. The number of relapses and complications did not differ between the two intervention groups. Five day treatment with penicillin V four times daily might be an alternative to the currently recommended 10 day regimen. Trial registration EudraCT 2015-001752-30; ClinicalTrials.gov NCT02712307 .

ERYTHROMYCIN PROPIONATE AND POTASSIUM PENICILLIN V IN THE TREATMENT OF GROUP A STREPTOCOCCAL PHARYNGITIS

PEDIATRICS ◽  
1963 ◽  
Vol 31 (1) ◽  
pp. 22-28
Author(s):  
Maxwell Stillerman ◽  
Stanley H. Bernstein ◽  
Martha Smith ◽  
Jack D. Gorvoy
Keyword(s):  
Relative Effectiveness ◽  
Streptococcal Pharyngitis ◽  
Group A Streptococci ◽  
Cure Rate ◽  
Acute Pharyngitis ◽  
Penicillin V ◽  
Daily Dose ◽  
Group A ◽  
Potassium Penicillin

The relative effectiveness of erythromycin propionate and K penicillin V in two dosage schedules was evaluated in the treatment of 261 cases of acute pharyngitis from which Group A hemolytic streptococci were recovered from December, 1958, to June, 1959. Erythromycin propionate, in a daily dose of 30 mg/kg up to 1.0 gm, and K penicillin V, in daily doses of 375 mg and 750 mg, were administered orally for 10 days. The adjusted bacterial cure rate was 78% among 86 patients treated with erythromycin, 72% among 102 patients treated with K penicillin V, 375 mg, and 88% among 73 patients treated with K penicillin V, 750 mg. The data indicate that K penicillin V was more effective in eradicating Group A streptococci from the pharynx in a daily dose of 750 mg than 375 mg, and suggest that erythromycin propionate in the dosage used, was less effective than K penicillin V, 750 mg, but equally as effective as K penicillin V, 375 mg daily. The incidence, time of occurrence, and results of retreatments of bacterial relapses are presented, and two possible causes of relapses are considered.

Persistence of group A streptococci as related to penicillinase-producing staphylococci: Comparison of penicillin V potassium and sodium nafcillin

1967 ◽  
Vol 71 (1) ◽  
pp. 132-137 ◽  
Author(s):  
Milton Markowitz ◽  
Irving Kramer ◽  
Eugene Goldstein ◽  
Anthony Perlman ◽  
Donald Klein ◽  
...  
Keyword(s):  
Group A Streptococci ◽  
Penicillin V ◽  
Group A ◽  
Sodium Nafcillin

scholarly journals A comparative prospective open label randomized controlled 8 week study in patients of depression treated with vilazodone and sertraline

2020 ◽  
Vol 7 (4) ◽  
pp. 643
Author(s):  
Nirmal Arya ◽  
Anuradha Nischal ◽  
Anil Nischal ◽  
Manu Agarwal
Keyword(s):  
Side Effect ◽  
Rating Scale ◽  
Sexual Experience ◽  
Open Label ◽  
Randomized Controlled ◽  
Parallel Group ◽  
Treatment Of Depression ◽  
Group A ◽  
Hamilton Anxiety Rating Scale ◽  
Group B

Background: Depression is a mood disorder treated with various antidepressant such as SSRIs due to lesser toxicity and improved safety profile.Methods: This was an eight week randomised active controlled parallel group study. 54 patients were allocated in two group. Group A received vilazodone while group B received sertraline. Assessment done at baseline, 2, 4 and 8 weeks on the basis of clinical efficacy, sexual dysfunction, side effects and weight gain using Hamilton Depression Rating Scale (HAM-D), Hamilton Anxiety Rating Scale (HAM-A), Arizona Sexual Experience Scale (ASEX) and UKU Side Effect Rating Scale.Results: HAM-D score of group A was 18.78±1.78 and 7.67±1.66 while in group B was 19.04±2.12 and 8.15±1.77 at baseline and 8 weeks respectively. HAM-A score of group A was 15.44±1.50 and 6.63±1.39 while in group B was 15.26±1.83 and 7.07±1.14 at baseline and 8 weeks. ASEX total score of group A was 15.63±1.28 and 14.63±1.33 while group B was 15.52±1.37 and 16.41±1.12 at baseline and 8 weeks. ASEX desire score of group A was 9.63±0.93 and 8.67±0.88 while of group B was 9.59±0.93 and 10.07±0.92 at baseline and 8 weeks. UKU side effect rating at 2 and 8 weeks of group A was 0.22±0.42, 1.04±0.76 while in group B was 0.37±0.49, 1.89±0.85.Conclusions: Vilazodone and Sertraline are equally efficacious in treatment of depression and associated anxiety. When side effect profile were compared Vilazodone is found superior to Sertraline

scholarly journals Antirelapse Efficacy of Various Primaquine Regimens for Plasmodium vivax

2014 ◽  
Vol 2014 ◽  
pp. 1-11 ◽  
Author(s):  
D. D. Rajgor ◽  
N. J. Gogtay ◽  
V. S. Kadam ◽  
M. M. Kocharekar ◽  
M. S. Parulekar ◽  
...  
Keyword(s):  
Plasmodium Vivax ◽  
Recurrence Rate ◽  
Relapse Rate ◽  
Continuous Monitoring ◽  
Standard Dose ◽  
Open Label ◽  
Randomized Controlled ◽  
Parallel Group ◽  
Pcr Rflp ◽  
Group A

Background. Efficacy of standard dose of primaquine (PQ) as antirelapse for P. vivax has decreased. We aimed to assess efficacy of different PQ regimens. Methods. It was an open label, randomized, controlled, parallel group, assessor blind study comparing antirelapse efficacy of 3 PQ regimens (B=15 mg/day × 14 days, C=30 mg/day × 7 days, and D=30 mg/day × 14 days) with no PQ group (A) in P. vivax patients. Paired primary and recurrence samples were subjected to 3 methods: (i) month of recurrence and genotyping, (ii) by PCR-RFLP, and (iii) PCR sequencing, to differentiate relapse and reinfection. The rates of recurrence relapse and reinfection were compared. Methods were compared for concordance between them. Results. The recurrence rate was 16.39%, 8.07%, 10.07%, and 6.62% in groups A, B, C, and D, respectively P=0.004. The relapse rate was 6.89%, 1.55%, 4%, and 3.85% as per the month of recurrence; 8.2%, 2%, 4.58%, and 3.68% P=0.007 as per PCR-RFLP; and 2.73%, 1.47%, 1.55%, and 1.53% as per PCR sequencing for groups A, B, C, and D, respectively. The concordance between methods was low, 45%. Conclusion. The higher recurrence rate in no PQ as compared to PQ groups documents PQ antirelapse activity. Regimens tested were safe. However, probable resistance to PQ warrants continuous monitoring and low concordance and limitations in the methods warrant caution in interpreting.

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