A study of 5-day cefdinir treatment for streptococcal pharyngitis in children

    Authors

    K. J. Tack; J. A. Hedrick; E. Rothstein; M. A. Nemeth; C. Keyserling;M. E. Pichichero

    Comments

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    Abbreviated Journal Title

    Arch. Pediatr. Adolesc. Med.

    Keywords

    ORAL CEPHALOSPORIN; INVITRO ACTIVITY; PENICILLIN; FK482; Pediatrics

    Abstract

    Objective: To compare the safety and efficacy of a 5-day regimen of cefdinir with those of a conventional 10-day regimen of penicillin V for the treatment of streptococcal pharyngitis in children. Design: Investigator-blind, randomized controlled trial. Setting: Primary care, ambulatory. Patients: Children aged 1 to 12 years with signs and symptoms of pharyngitis and a positive result on a rapid screening test for Streptococcus pyogenes (ie, a convenience sample). Four hundred eighty-two patients were enrolled in the study, and 440 were clinically and microbiologically evaluable. The most common reasons patients were nonevaluable were failure to return for specified fled visits and noncompliance with the administration of the medication; 2 patients receiving penicillin V discontinued use of the drug because of adverse events. Intervention: Patients were randomized to receive either 7-mg/kg cefdinir, twice daily, for 5 days or 10-mg/kg penicillin V potassium, 4 times daily, for 10 days. Main Outcome Measures: The eradication of S pyogenes and the clinical cure of the signs and symptoms of pharyngitis, both determined 5 to 10 days after the completion of therapy. Results: Streptococcus pyogenes was eradicated in 201 (90%) of the 224 patients receiving cefdinir and 155 (72%) of the 216 patients receiving penicillin V (95% confidence interval [CI], 10.7%-25.1%; P < .001). The clinical cure rates were 92% and 91% in the groups receiving cefdinir and penicillin V, respectively (95% CI, -4.5% to 6.1%; P = .80). Adverse events, regardless of the opinion of the investigator about their relationship to the study medication, occurred in 12.5% of the patients receiving cefdinir and 13.6% of the patients receiving penicillin V (P = .69). Conclusions: A 5-day regimen of cefdinir eradicated a higher proportion of S pyogenes than a 10-day regimen of penicillin V. No difference was noted between the regimens for clinical outcomes or adverse event rates.

    Journal Title

    Archives of Pediatrics & Adolescent Medicine

    Volume

    151

    Issue/Number

    1

    Publication Date

    1-1-1997

    Document Type

    Article

    Language

    English

    First Page

    45

    Last Page

    49

    WOS Identifier

    WOS:A1997WC69600007

    ISSN

    1072-4710

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