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

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.

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 .

EPIDEMIOLOGY OF A STREPTOCOCCAL OUTBREAK IN A SCHOOL: ATTEMPT AT CONTROL BY MASS PROPHYLAXIS WITH PENICILLIN V

PEDIATRICS ◽  
1958 ◽  
Vol 21 (4) ◽  
pp. 624-634
Author(s):  
David C. Poskanzer ◽  
Harry A. Feldman ◽  
Thomas W. Mou ◽  
Kenzo Kuroda
Keyword(s):  
Age Distribution ◽  
Group A Streptococci ◽  
Once Daily ◽  
Penicillin V ◽  
Focus Of Infection ◽  
Group A ◽  
Resistance To Penicillin ◽  
The Individual ◽  
Families With Children ◽  
Made In

An attempt was made to abort an epidemic of streptococcal infection in a rural school including kindergarten through third grade by the use of mass, oral penicillin V prophylaxis for 10 days. Half of the classes received 200,000 units of penicillin V once daily and the others received two doses daily. In both instances, there was a decline in the carrier rates but neither regimen was entirely satisfactory. Unusual resistance to penicillin could not be demonstrated in streptococci isolated after the treatment period. Carrier studies were conducted in 124 families of children in the school sample. Prior to the prophylaxis regimen the carrier rate for Group A streptococci was 7% for adults more than 24 years of age and 24% in their children in the school being studied. Forty families which did not have children in the school also were cultured. None of the adults more than 24 years of age in this group was found to have streptococci in contrast with 4% of adults (cultured the same day) in the school-associated families. These observations tend to support the hypothesis that the school is the focus of infection and that families with children in school have a higher rate of infection than families without children in school. However, in both groups of families the adults appeared to be relatively resistant to infection. Within the school, the focus of infection appeared to be the individual classroom rather than the grade level. Rates of positive cultures for Group A streptococci in different classrooms within the same grade ranged from 0 to 71%. Numerous isolations of Group C streptococci were made in the school population. The age distribution paralleled the age distribution of the children from whom Group A organisms were isolated. In addition, titers of antistreptolysin-O in persons from whom Group C organisms were isolated were similar to those in persons with Group A strains. It is suggested that Group C infections may have contributed to the course of the epidemic.

EFFECT OF PENICILLINS V AND G ON CARRIERS OF VARIOUS GROUPS OF STREPTOCOCCI IN A CHILDREN'S HOME

PEDIATRICS ◽  
1957 ◽  
Vol 19 (2) ◽  
pp. 208-216
Author(s):  
Paul F. Wehrle ◽  
Harry A. Feldman ◽  
Kenzo Kuroda
Keyword(s):  
Oral Dose ◽  
Clinical Disease ◽  
Penicillin G ◽  
Age Group ◽  
Group A Streptococci ◽  
Daily Oral Dose ◽  
Penicillin V ◽  
Children's Home ◽  
High Incidence ◽  
Group A

Penicillin V satisfactorily eliminated Group A streptococci from the nasopharynx of carriers when used in a total daily oral dose of 400,000 units administered in two divided doses, morning and evening during a 10-day period. Half this dose for a similar 10-day period was considerably less effective. These results were entirely comparable with those observed with penicillin G administered in single or double doses of 250,000 units daily for 10- day periods under the conditions of this study. The need for daily doses of at least 400,000 units of penicillin V or 500,000 units of penicillin G for effective eradication of streptococci from carriers has been demonstrated. A high incidence of infection with streptococci of Group G was observed but did not appear to be associated with clinical disease. No increased prevalence of Group G organisms was apparent among any age group or in any of the apartments studied in contrast with Group A infections.

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