A pooled comparison of cefdinir and penicillin in the treatment of group a beta-hemolytic streptococcal pharyngotonsillitis.

Author(s): Brook I

Affiliation(s): Department of Pediatrics, Georgetown University School of Medicine, Washington, DC, USA. ib6@georgetown.edu

Publication date & source: 2005-08, Clin Ther., 27(8):1266-73.

Publication type:

OBJECTIVE: This pooled analysis compared the clinical cure and bacterial eradication rates achieved by cefdinir and penicillin in the treatment of group A beta-hemolytic streptococcal (GABHS) pharngotonsillitis. METHODS: Data from 4 multicenter, randomized, controlled, investigator-blinded trials, 2 in children receiving oral suspensions and 2 in adults receiving capsules/tablets, were pooled and analyzed in terms of clinical cure rates, microbiologic eradication rates, and adverse events. RESULTS: A total of 2751 patients were enrolled (age <13 years, n = 1274; age > or =13 years, n = 1477). Patients were randomized to receive cefdinir once daily (n = 569) or twice daily (n = 1086) for 5 or 10 days, or penicillin 4 times daily (n = 1096) for 10 days. Of the 2751 patients enrolled, 2198 were evaluable for clinical and microbiologic outcomes. Compared with the 10-day penicillin regimens, the cefdinir regimens for 5 or 10 days produced higher clinical cure and microbiologic eradication rates. Combined clinical cure rates were significantly higher for cefdinir compared with penicillin (94% vs 83%, respectively; P < 0.001). Combined microbiologic eradication rates were also significantly higher for cefdinir compared with penicillin (92% vs 77%; P < 0.001). Both cefdinir and penicillin were well tolerated, as >98% of patients completed the course of therapy. CONCLUSION: In this pooled analysis of data from 4 multicenter, randomized, controlled, investigator-blinded trials in children and adults, 5- and 10-day regimens of cefdinir achieved significantly higher clinical cure and microbiologic eradication rates compared with 10-day penicillin regimens in the treatment of GABHS pharyngotonsillitis.