Treatment of Streptococcal Pharyngitis with Once-daily Amoxicillin Versus Intramuscular Benzathine Penicillin G in Low-resource Settings: a Randomized Controlled Trial

Overview

Journal Clin Pediatr (Phila)

Publisher Sage Publications

Specialty Pediatrics

Date 2011 Feb 15

PMID 21317198

Citations 7

Authors

Anne W Rimoin

Nicole A Hoff

Christa L Fischer Walker

Hala S Hamza

Adriana Vince

Naglaa Abdel Rahman

Sasa Andrasevic

Soha Emam

Dubravka Vukelic

Nevine Elminawi

Hadeer Abdel Ghafar

Antonia L A da Cunha

Shamim Qazi

Dace Gardovska

Mark C Steinhoff

Affiliations

Soon will be listed here.

Abstract

Background: Primary prevention of acute rheumatic fever is achieved by proper antibiotic treatment of group A β -hemolytic streptococcal (GAS) pharyngitis.

Methods: To assess noninferiority of oral amoxicillin to intramuscular benzathine penicillin G (IM BPG). Children (2 to 12 years) meeting enrollment criteria were randomized 1:1 to receive antibiotic treatment in 2 urban outpatient clinics in Egypt and Croatia.

Results: A total of 558 children (Croatia = 166, Egypt = 392) were randomized, with 368 evaluable in an intention-to-treat (ITT) analysis, and 272 evaluable in the per protocol (PP) analysis. In Croatia, ITT and PP treatment success rates were comparable for IM BPG and amoxicillin (2.5% difference vs 1.1% difference, respectively). In Egypt, amoxicillin was not comparable with IM BPG in ITT analysis (15.1% difference), but was comparable in PP analysis (-9.3% difference).

Conclusion: If compliance is a major issue, a single dose of IM BPG may be preferable for treatment of GAS pharyngitis.

Citing Articles

Different antibiotic treatments for group A streptococcal pharyngitis.

Hedin K, Thorning S, Van Driel M Cochrane Database Syst Rev. 2023; 11:CD004406.

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Group A β-hemolytic Streptococcal Pharyngitis: An Updated Review.

Leung A, Lam J, Barankin B, Leong K, Hon K Curr Pediatr Rev. 2023; 21(1):2-17.

PMID: 37493159 DOI: 10.2174/1573396320666230726145436.

Treatment outcomes of acute streptococcal tonsillitis according to antibiotic treatment. A retrospective analysis of 242,366 cases treated in the community.

Bar-Yishay M, Yehoshua I, Bilitzky A, Press Y Eur J Gen Pract. 2022; 28(1):142-149.

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Different antibiotic treatments for group A streptococcal pharyngitis.

Van Driel M, De Sutter A, Thorning S, Christiaens T Cochrane Database Syst Rev. 2021; 3:CD004406.

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Guidelines for the Antibiotic Use in Adults with Acute Upper Respiratory Tract Infections.

Yoon Y, Park C, Kim J, Hwang K, Lee S, Kim T Infect Chemother. 2018; 49(4):326-352.

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