Treatment of Group A Streptococcal Pharyngitis in Children

Abstract

Penicillin V, benzathine/procaine penicillin G, cefadroxil monohydrate, and erythromycin estolate were randomly assigned for therapy of group A streptococcal pharyngitis in 198 children. All patients improved with in 24 hours of initiating therapy. Reinfection with a new group A streptococcal serotype occurred in 13 patients, 12 developing 7 to 12 days after stopping therapy and 11 becoming symptomatic. Relapse with the same organism occurred in 16 patients, only 5 (31%) of whom were symptomatic. Antibody titer rises, antibiotic resistance of group A organisms, presence of penicillinase-producing staphylococci, and lack of compliance were not related to recurrent infections. There were no significant differences between the failure rates of the four test drugs: penicillin V, 12%; benzathine/procaine penicillin G, 12%; cefadroxil monohydrate, 5%; and erythromycin, 2%.

Time to negative throat culture following initiation of antibiotics for pharyngeal group A Streptococcus: a systematic review and meta-analysis up to October 2021 to inform public health control measures

“…Five studies reported intramuscular penicillin therapy; results were consistent with our findings for antibiotics overall [31,34,40,54,55]. Snellman et al found 1/15 (6.7%) children were culture-positive at 24 h following single dose benzathine penicillin [31].…”

“…Brook et al [65] Edmond et al [59] Edmond et al [59] Schalet et al [60] Schalet et al [60] Schwartz et al [32] Snellman et al [31] Gerber et al [45] Gerber et al [45] Gerber et al [ [35] Heterogeneity between groups: p = 0.841 Pooled estimate: 10.4% (95% CI: 8.6-12.5) Block et al [94] Block et al [94] Pooled estimate: 10.2% (95% CI: 6.3-16.2) Pooled estimate: 10.5% (95% CI: 7.9-13.9) Lester et al [34] Block et al [94] Watkins et al [37] Milatovic et al [93] Pacifico et al [58] Ginsburg et al [33] Ginsburg et al [89] Watkins et al [37] Block et al [94] Pichichero et al [95] Aronovitz et al [85] Gerber et al [45] Howie et al [54] Aronovitz et al [85] Lennon et al [50] Gerber et al [45] Lennon et al [50] Howie et al [54] Lennon et al [50]…”

“…Ten studies investigated macrolides [31,[33][34][35][36][37][38][39][40][41], three clindamycin [34,36,42] and two co-trimoxazole [43,44],…”