Cefcanel Daloxate versus Penicillin in Acute Streptococcal Pharyngotonsillitis

Abstract

A GRUNFELD, P SINCLAIR, LE NICOLLE AND THE CANADIAN TONSILLITIS STUDY GROUP. Cefcanel daloxate versus penicillin in acute streptococcal pharyngotonsillitis. Can J Infect Dis 1994;5(3):119-124. OBJECTIVE: To de termine the efficacy, safety and tolerance of cefcanel d a loxate and ph enoxymethylpenicillin (PcV) in the trealmen l of acule ph aryngo tonsillitis caused by bela-hemolytic streptococci group A (BHSGA). PATIENTS AND METHoos: Randomized, double-blind, multicentre sludy with subjects randomized 1: 1: 1: 1 lo four parallel trealmenl groups: cefcanel daloxale 150 mg bid. 300 mg b id, 600 mg daily and PcV 300 mg tid. Patients were treated for 10 days with clinical. bacteriological and safely evaluation al inclusion . during therapy (day 5), early after completion of therapy (day 14) and lwo weeks laler (day 28) . REsULTS: Of 340 subjects enrolled, 324 were valid for safely analysis and 249 for efficacy analysis. At the short term visit, clinical cure rales for cefcanel daloxale 300 mg bid and PcV groups were s imilar al approximately 70%. The cure rates for cefcanel daloxale 150 mg bid and 600 mg daily were significantly worse at 57.4 and 54.4%. Approximately 80% of all prethempy throal swabs grew BIISGA. All BHSGA were susceptible or intermediately susceptible to PcV and cefcanel. The bacteria l elimination rate for cefcanel daloxate was 82.8% and for PcV it was 89 .8%. The elimination rate was s ignificantly lower in the cefcanel daloxate 150 mg bid and 6 00 mg daily gro u ps. The clin ical cure rates and U1e bacteriological elimination rates increased by about 10% for cefcanel daloxate 300 mg bid and the PcV groups at the lasl valid visit and rem ained s ignificantly better than tl1e other two cefcanel daloxate doses. Adverse events were not significantly different among the four treain1enl groups. CONCLUSIONs: Cefcanel daloxate 300 mg b id was as effective and as well tolerated as PcV 300 mg tid in the treatment of acute pharyngotonsillitis. A lower dose or once-daily dose regimen of cefcanel daloxate was not as effective clinically or bacleriologically. (Pour resume. voir