Five versus ten days treatment of group A streptococcal pharyngotonsillitis: a randomized controlled clinical trial with phenoxymethylpenicillin and cefadroxil.

Author(s): Stromberg A, Schwan A, Cars O

Affiliation(s): Department of Infectious Diseases, Uppsala University Hospital, Sweden.

Publication date & source: 1988, Scand J Infect Dis., 20(1):37-46.

Publication type: Clinical Trial; Randomized Controlled Trial

216 patients aged greater than or equal to 7 years with febrile group A streptococcal pharyngotonsillitis were randomly assigned to 3 treatment groups receiving either phenoxymethylpenicillin for 5 days followed by placebo for 5 days, phenoxymethylpenicillin for 10 days, or cefadroxil for 10 days. 209 patients completed treatment, 70 subjects in each phenoxymethylpenicillin group and 69 in the cefadroxil group. Within 1 week after completion of the antibiotic treatment significantly more recurrences with the same T-type as the initial streptococcal strain occurred in the 5-day treatment group (27%) as compared with the two 10-day groups (6% and 3%, respectively). The cumulative rate of recurrences (irrespective of T-type) within 2 months from the start of therapy was 55% among patients treated with phenoxymethylpenicillin for 5 days, 24% among those treated for 10 days with this drug and 19% among patients receiving cefadroxil. Obviously, one important factor to avoid recurrence of group A streptococcal pharyngotonsillitis is the length of antibiotic treatment and, in our opinion, it is not advisable to change the current recommendation of 10 days treatment.