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 ◽  
...  

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.

2002 ◽  
Vol 20 (1) ◽  
pp. 28-33 ◽  
Author(s):  
Susanna Esposito ◽  
Paola Marchisio ◽  
Samantha Bosis ◽  
Roberta Droghetti ◽  
Roberto Mattina ◽  
...  

2008 ◽  
Vol 93 (6) ◽  
pp. 474-478 ◽  
Author(s):  
D R Lennon ◽  
E Farrell ◽  
D R Martin ◽  
J M Stewart

1997 ◽  
Vol 41 (1) ◽  
pp. 72-75 ◽  
Author(s):  
V S Watkins ◽  
M Smietana ◽  
P M Conforti ◽  
G D Sides ◽  
W Huck

In the treatment of group A beta-hemolytic streptococcal pharyngitis, penicillin is the drug of choice and erythromycin is the alternative. In a double-blind, randomized study, dirithromycin, a new macrolide, was compared with penicillin for the treatment of streptococcal pharyngitis. Of 121 patients who were treated with dirithromycin, 96.7% manifested a favorable clinical response, and of 136 patients treated with penicillin, 94.2% manifested a favorable clinical response. Streptococci were eradicated from the pharynges of 85.3% of 116 dirithromycin-treated patients and 82.5% of 126 penicillin-treated patients who returned for follow-up. There were no statistically significant differences in efficacy between the two groups. The incidence of abdominal symptoms was higher in dirithromycin-treated patients. Being as efficacious as penicillin and having the advantages over erythromycin of once-daily dosing and the lack of drug interactions, dirithromycin is an alternative to penicillin in the treatment of streptococcal pharyngitis for patients 12 years of age and older.


1998 ◽  
Vol 42 (5) ◽  
pp. 1073-1075 ◽  
Author(s):  
Kenneth J. Tack ◽  
Daniel C. Henry ◽  
W. Manford Gooch ◽  
Douglas N. Brink ◽  
Constance H. Keyserling ◽  
...  

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.


1998 ◽  
Vol 42 (1) ◽  
pp. 114-120 ◽  
Author(s):  
S. Chodosh ◽  
S. Lakshminarayan ◽  
H. Swarz ◽  
S. Breisch

ABSTRACT A randomized, prospective, double-blind, double-dummy, multicenter study investigated the efficacy and safety of 10 days of oral therapy with grepafloxacin at 400 mg once daily, grepafloxacin at 600 mg once daily, or ciprofloxacin at 500 mg twice daily in 624 patients with acute bacterial exacerbations of chronic bronchitis. At the end of treatment, clinical success (cure or improvement) was achieved for 93% (140 of 151), 88% (137 of 156), and 91% (145 of 160) of patients in the groups receiving grepafloxacin at 400 mg, grepafloxacin at 600 mg, and ciprofloxacin, respectively (clinically evaluable population). At follow-up (14 to 28 days posttreatment), the clinical success rates were 87% (124 of 143), 81% (122 of 151), and 80% (123 of 154) in the groups receiving grepafloxacin at 400 mg and 600 mg and ciprofloxacin, respectively. A total of 379 pathogens were isolated from 290 patients, with the most common isolates being Moraxella catarrhalis(21%), Staphylococcus aureus (20%), Haemophilus influenzae (18%), and Streptococcus pneumoniae(7%). For the evaluable population, successful bacteriologic response was obtained at the end of treatment for 96% (92 of 96), 98% (87 of 89), and 92% (82 of 90) of patients receiving grepafloxacin at 400 mg, grepafloxacin at 600 mg, and ciprofloxacin, respectively, and was maintained in 86% (82 of 95), 88% (78 of 89), and 82% (69 of 84) of patients, respectively, at follow-up. All pretreatment S. pneumoniae isolates were susceptible to grepafloxacin, but two strains were resistant to ciprofloxacin. All treatments were well tolerated, with the most frequently reported drug-related adverse events being nausea, taste perversion, and headache. All drug-related adverse events in the grepafloxacin groups were mild or moderate in severity. This study demonstrates that 10-day courses of grepafloxacin given at 400 or 600 mg once daily were as effective, clinically and bacteriologically, as ciprofloxacin given at 500 mg twice daily for the treatment of acute bacterial exacerbations of chronic bronchitis.


2021 ◽  
Author(s):  
Wei Xiong ◽  
Yunfeng Zhao ◽  
He Du ◽  
Yanmin Wang ◽  
Xuejun Guo ◽  
...  

Abstract Background: Sequential low molecular weight heparin(LMWH) plus warfarin, LMWH plus edoxaban as well as LMWH plus dabigatran regimens have already showed efficacy and safety in the treatment of acute pulmonary embolism(PE). The efficacy and safety of sequential LMWH plus rivaroxaban regimen in the treatment of PE has been understudied. Methods: A retrospective study was performed to explore the efficacy and safety of sequential therapy regimens of subcutaneous LMWH( nadroparin 4100 IU every 12 hours for a week) followed by oral rivaroxaban(20mg once daily for 3 months) in the management of patients with established acute PE without hemodynamic instability, compared with those of LMWH plus dabigatran as well as LMWH plus warfarin.Results: The number of patients with total resolution of PE were 238(80.1%), 220(78.0%) and 166(62.6%), in the LMWH+rivaroxaban, LMWH+dabigatran, and LMWH+warfarin groups, respectively. (P=0.001) The prevalence of DVT at the 3-month follow-up visit were 18(6.1%), 14(5.0%) and 11(4.2%), in the aforementioned three groups, respectively.(P=0.559) The NT-proBNP level (pg/mL) at the 3-month follow-up visit were 122.5(97.4-158.9) , 131.7(102.2-166.3), and 357.8(275.4-433.2) in three groups, respectively.(P=0.001) The D-dimer level (ng/mL) at the 3-month follow-up visit were 387.3(310.9-465.2) , 432.5(382.4-489.6), and 854.0(721.5-993.7) in three groups, respectively.(P<0.001) The number of patients with major bleeding events were 3(0.9%), 6(1.8%), and 18(5.5%) in three groups, respectively. (P<0.001)Conclusions: The regimen of sequential subcutaneous LMWH for a week followed by oral rivaroxaban at a dose of 20mg once daily for three months is effective and safe in the initial treatment of patients with acute pulmonary embolism.


PEDIATRICS ◽  
1963 ◽  
Vol 31 (1) ◽  
pp. 22-28
Author(s):  
Maxwell Stillerman ◽  
Stanley H. Bernstein ◽  
Martha Smith ◽  
Jack D. Gorvoy

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.


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