Clinical Cure of Group A Streptococcal Pharyngotonsillitis with a 5 day treatment of Penicillin V

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Carol Motley ◽  
Soo-Ryun Ahn ◽  
Sitembile Lee
Keyword(s):  
Clinical Cure ◽  
Day Treatment ◽  
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 .

scholarly journals Treatment of enteric fever with pefloxacin for 7 days versus 5 days: a randomized clinical trial.

1996 ◽  
Vol 40 (12) ◽  
pp. 2898-2900 ◽  
Author(s):  
S Unal ◽  
M Hayran ◽  
S Tuncer ◽  
D Gür ◽  
O Uzun ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Clinical Cure ◽  
Enteric Fever ◽  
Day Treatment ◽  
Salmonella Typhi ◽  
Bacterial Eradication ◽  
Salmonella Spp ◽  
Group A ◽  
Paratyphi B ◽  
Group B

In this prospective study of enteric fever, 22 patients received 400 mg of pefloxacin twice daily for 5 days (group A) and 24 received 400 mg of pefloxacin twice daily for 7 days (group B). Causative microorganisms were Salmonella typhi (8 in group A, 11 in group B) and Salmonella paratyphi B (14 in group A, 13 in group B). The clinical cure and bacterial eradication rates were 96% (21 of 22) in group A and 100% in group B. In conclusion, 5-day oral administration of pefloxacin was as effective as 7-day treatment of enteric fever caused by Salmonella spp.

scholarly journals Five-Day Cefdinir Treatment for Streptococcal Pharyngitis

1998 ◽  
Vol 42 (5) ◽  
pp. 1073-1075 ◽  
Author(s):  
Kenneth J. Tack ◽  
Daniel C. Henry ◽  
W. Manford Gooch ◽  
Douglas N. Brink ◽  
Constance H. Keyserling ◽  
...  
Keyword(s):  
Day Treatment ◽  
Signs And Symptoms ◽  
Reaction Rates ◽  
Streptococcal Pharyngitis ◽  
Oral Penicillin ◽  
Penicillin V ◽  
Long Term Follow Up ◽  
Group A ◽  
Cure Rates

ABSTRACT A multicenter, randomized, controlled, investigator-blind study was performed to evaluate the safety and efficacy of oral cefdinir versus oral penicillin V for the treatment of pharyngitis due to group A beta-hemolytic streptococci (GABHS). Patients 13 years of age and older were randomized to receive either oral cefdinir (300 mg twice a day) for 5 days followed by placebo for 5 days or oral penicillin V (250 mg four times a day) for 10 days. Throat cultures were obtained, and signs and symptoms of pharyngitis were recorded at study admission and follow-up visits on study days 11 to 15, 16 to 20, and 25 to 31. Patients kept a diary to record medication intake and their assessment of throat pain at admission and at each day of study treatment. Five hundred fifty-eight patients were enrolled, of whom 432 (77.4%) were clinically and microbiologically evaluable. The GABHS eradication rates 5 to 10 days after completion of therapy were 193 of 218 (88.5%) in the cefdinir group and 176 of 214 (82.2%) in the penicillin group (P = 0.053). Clinical cure rates were 89.0 and 84.6%, respectively (P = 0.80). By the time of the long-term follow-up visit, 2 to 3 weeks after completion of treatment, 156 of 191 (81.7%) of the assessable cefdinir patients and 152 of 195 (77.9%) of the penicillin patients remained free of GABHS. Both treatments were well tolerated, with adverse reaction rates of 18.3% in the cefdinir study arm and 15.0% in the penicillin study arm (P = 0.278). Five-day treatment with cefdinir is safe and effective therapy for GABHS pharyngitis. Based on its twice-a-day dosage and shorter course of therapy, leading to potentially greater patient compliance, cefdinir may be considered for use in the treatment of pharyngitis caused by GABHS.

scholarly journals Effects of aqueous leaf extract of Corchorus olitorius on the testis and blood testosterone level of adult Wistar rats

2021 ◽  
Vol 10 (2) ◽  
pp. 024-030
Author(s):  
Godwin Chinedu Uloneme ◽  
Demian Nnabuihe Ezejindu ◽  
Darlington Cyprian Akukwu ◽  
Amadi Chibundu Chiekezie
Keyword(s):  
Body Weight ◽  
Wistar Rats ◽  
Day Treatment ◽  
Control Group ◽  
Corchorus Olitorius ◽  
Group A ◽  
Normal Rat ◽  
Group B ◽  
Calcium Iron ◽  
Group D

Background: The extract of Corchorus olitorius has a reasonable content of vitamins A and C, calcium, iron and fibre, and therefore enjoys a universal application in the treatment of some disease conditions, even as the whole leaf is a very important component of food in so many cultures. Purpose: The study was designed to investigate the effect of Corchorus olitorius extracts on the testis of adult Wistar rats. Method: A total number of thirty two adult Wistar rats weighing between 180 and 200 grammes separated into four groups labeled A,B,C and D respectively were used for the study. Animals in group A which served as the control group were fed with the normal rat chow and water only. The group B rats were administered 100mg/kg body weight of aqueous extract of Corchorus olitorus; while those in group C were administered 500mg/kg body weight of the extract. The group D rats received 1000mg/kg body weight of the extract. For a period of four weeks, the different experimental animal groups received the respective aforementioned treatments once daily, around nine- o’clock in the morning through oral intubation. At the end of the 28 day treatment, the animals were sacrificed and the testes harvested for histological, investigation, and through cardiac puncture, blood samples for some hormonal studies was also collected and investigated using standard laboratory standards. Results: Observations made showed that the extract produced no histological distortions, degenerative or defective effects on the testicular tissues. The testosterone levels of group B, C, and D rats were observed to be significantly higher (P<0.005) than that of the group A (control group).ound: The extract of Corchorus olitorius has a reasonable content of vitamins A and C, calcium, iron and fibre, and therefore enjoys a universal application in the treatment of some disease conditions, even as the whole leaf is a very important component of food in so many cultures. Purpose: The study was designed to investigate the effect of Corchorus olitorius extracts on the testis of adult Wistar rats. Method: A total number of thirty two adult Wistar rats weighing between 180 and 200 grammes separated into four groups labeled A,B,C and D respectively were used for the study. Animals in group A which served as the control group were fed with the normal rat chow and water only. The group B rats were administered 100mg/kg body weight of aqueous extract of Corchorus olitorus; while those in group C were administered 500mg/kg body weight of the extract. The group D rats received 1000mg/kg body weight of the extract. For a period of four weeks, the different experimental animal groups received the respective aforementioned treatments once daily, around nine- o’clock in the morning through oral intubation. At the end of the 28 day treatment, the animals were sacrificed and the testes harvested for histological, investigation, and through cardiac puncture, blood samples for some hormonal studies was also collected and investigated using standard laboratory standards. Results: Observations made showed that the extract produced no histological distortions, degenerative or defective effects on the testicular tissues. The testosterone levels of group B, C, and D rats were observed to be significantly higher (P<0.005) than that of the group A (control group).

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 452. Antibiotic Duration, but Not Size, Impacts Clinical Cure of Limited Skin and Soft-Tissue Infection After Incision and Drainage

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S222-S223
Author(s):  
Jason G Lake ◽  
Stephanie Fritz
Keyword(s):  
Antibiotic Therapy ◽  
Antibiotic Treatment ◽  
Clinical Cure ◽  
Day Treatment ◽  
Treatment Protocol ◽  
Chi Square ◽  
Incision And Drainage ◽  
Exact Test ◽  
Days Of Therapy ◽  
Antibiotic Duration

Abstract Background Incision and drainage (I&D) is the most common treatment for skin abscesses. A recent randomized clinical trial (RCT) of outpatients with limited (≤5 cm) skin abscesses demonstrated antibiotic therapy with clindamycin or trimethoprim-sulfamethoxazole (TMP-SMX) was superior to I&D alone. We performed a subgroup analysis to measure the effect of antibiotic duration and abscess size on clinical cure at 7–10 days after antibiotic completion. Methods Participants with complete data regarding adherence to the 10-day treatment were included. Demographic and baseline clinical features were compared using t-test, Pearson’s chi-square or Fisher’s exact test, or a non-parametric equivalent where appropriate. Largest abscess dimension (cm) was dichotomized by median size. The effect of antibiotic duration, abscess size (≤ median vs. >median) and covariates on clinical cure were measured using logistic regression. Breslow-Day Test for Homogeneity was used to assess the interaction between treatment and abscess size. Results Of 786 participants in the intention-to-treat analysis, complete adherence data were available for 680 (87%) participants. Of these, 463 (68%) received either antibiotic: 421 (91%) completed 10 days of therapy, 29 (6.3%) ≤7 days and 20 (4.3%) ≤5 days. Only antibiotic treatment duration was associated with clinical cure (table). Odds of clinical cure were 1.7 (95% CI: 1.5, 2.0) times higher for each additional day of treatment. Median abscess size was 2.5 cm (range: 0.2–5); 364 participants had abscesses ≤ median vs. 316 >median. Assessed continuously, abscess size was not associated with cure within antibiotic groups (table) or between placebo and treatment groups (OR 0.94, 95% CI: 0.58–1.5). Stratifying on size, no significant interaction was observed with antibiotic treatment (Breslow-Day P = 0.13). Conclusion Adherence to the treatment protocol was high. These data suggest that longer courses of antibiotic therapy in conjunction with I&D are associated with successful treatment of limited skin abscesses. Size was not associated with clinical cure. Prospective RCTs to determine the optimal length of treatment are needed. Disclosures All authors: No reported disclosures.

scholarly journals Comparative efficacy and safety of 3-day azithromycin and 10-day penicillin V treatment of group A beta-hemolytic streptococcal pharyngitis in children.

1996 ◽  
Vol 40 (4) ◽  
pp. 1005-1008 ◽  
Author(s):  
L Pacifico ◽  
F Scopetti ◽  
A Ranucci ◽  
M Pataracchia ◽  
F Savignoni ◽  
...  
Keyword(s):  
Clinical Success ◽  
Streptococcal Pharyngitis ◽  
Efficacy And Safety ◽  
Comparative Efficacy ◽  
Once Daily ◽  
Penicillin V ◽  
Oral Regimen ◽  
Beta Hemolytic Streptococcus ◽  
Group A

The efficacy and safety of a 3-day course of azithromycin oral suspension (10 mg/kg of body weight once daily) were compared with those of penicillin V (50,000 U/kg/day in two divided doses) in children aged 3 to 12 years for the treatment of symptomatic pharyngitis caused by the group A beta-hemolytic streptococcus (GABHS). For the 154 evaluable patients, the original infecting strain of GABHS was eliminated at the end of follow-up (34 to 36 days after treatment started) from 67 (85.8%) of 78 penicillin-treated patients and 41 (53.9%) of 76 azithromycin-treated patients (P < 0.0001). Overall clinical success was achieved in 71 (91.0%) of 78 penicillin V-treated patients and 57 (75.0%) of 76 azithromycin-treated patients (P < 0.05). Potential drug-related adverse events were reported for 5.5 and 8.6% of the penicillin V- and azithromycin-treated patients, respectively (P = 0.6). In the present study, a once-daily (10 mg/kg), 3-day oral regimen of azithromycin was as safe as a 10-day course of penicillin but did not represent an effective alternative to penicillin for the treatment of GABHS pharyngitis, even for those children with azithromycin-susceptible strains.

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