Comparing performance of amoxicillin and intramuscular benzathine penicillin in relieving manifestations of <i>Streptococcal pharyngitis</i> in children

Abstract

SUMMARYObjective: To compare clinical and bacteriologic responses to intramuscular benzathine penicillin G (BPG) and single dose of amoxicillin in Group A streptococcal (GAS) pharyngitis. Design: This study included 571 children from 6 to 15 years old age, with pharyngitis, who were admitted to 45 elementary and guidance schools from 7 regions of Education Organization in North-East of Iran, Mashhad. They were screened for enrollment and if he/she presented pharyngitis with clinical criteria of sore throat, erythema, exudate and tender or enlarged anterior cervical lymph nodes. Exclusion criteria included reports of antibiotic use, negative throat culture for GAS and history of allergy to the drugs. Clinical and bacteriologic responses to BPG and once daily orally amoxicillin were considered and compared. Results: In the amoxicillin group, treatment failure was more than the penicillin group (18.9% vs. 6.4%, respectively) but the difference was not statistically significant (p < 0.05). Both drugs were significantly effective in reducing pharyngitis manifestations but penicillin was significantly more effective in reducing exudate than amoxicillin. Conclusion: Our study was in line with studies comparing the two drugs. The results show that once-daily therapy with amoxicillin is as effective as intramuscular benzathine penicillin G for the treatment of GAS pharyngitis, but penicillin was significantly more effective in reducing exudate and concurrent signs vs. amoxicillin.

A clinical decision rule for streptococcal pharyngitis management: An update

“…We should explain that this article and the similar article[ 13 ] were derived from a research project that had been funded by a grant from the research and education foundation of our university with the code: NCT01310361.…”

“…This research project as a cross-sectional study performed on 6–15-year-old elementary and high-school children from seven different regions of North-East of Iran, Khorasan, Mashhad, from March 2012 to March 2013. [ 13 ] They were screened for enrollment as pharyngitis with clinical criteria of sore throat, erythema, exudate, and tender or enlarged anterior cervical lymph nodes (larger than 1.5 cm). Exclusion criteria were considered: Oral antibiotics use within the preceding 3 days or intramuscularly administered antibiotics within the 28 days prior to the visit which may modify clinical presentation of streptococcal pharyngitis, history of previous ARF or rheumatic heart disease, presence of another illness, and to be carrier.…”

“…Exclusion criteria were considered: Oral antibiotics use within the preceding 3 days or intramuscularly administered antibiotics within the 28 days prior to the visit which may modify clinical presentation of streptococcal pharyngitis, history of previous ARF or rheumatic heart disease, presence of another illness, and to be carrier. [ 13 14 ] The method of sampling was nonprobability, easy sampling. When we considered P < 0.05, confidence level 95%, and permissible error 1%, at least 97 children with GAS positive throat culture were expected as sample size.…”

“…We did not RDT strategy that its negative results should be confirmed by culture and has a median false-negative rate of 11%. [ 13 15 16 ] The physician applied throat culture soaps that were sent to a reference laboratory. Ninety-nine patients had throat swabs that yielded positive results on culture.…”

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

“…Therefore, IM benzathine penicillin G may be used for patients deemed to have difficulty complying with a 10-day oral antibiotic regimen [ 12 60 61 ]. Studies have found no significant differences in the clinical efficacy of 10-day amoxicillin oral antibiotic therapy and single IM injection of benzathine penicillin G [ 61 62 ].…”