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Treatment of Group A Streptococcal Pharyngitis in Children

Results of a Prospective, Randomized Study of Four Antimicrobial Agents

Department of Pediatrics, The University of Texas Health Science Center at Dallas, Southwestern Medical School, Dallas, Texas

George H. McCracken, JR

Department of Pediatrics, The University of Texas Health Science Center at Dallas, Southwestern Medical School, Dallas, Texas

Joel B. Steinberg

Department of Pediatrics, The University of Texas Health Science Center at Dallas, Southwestern Medical School, Dallas, Texas

Stephen D. Crow

Department of Pediatrics, The University of Texas Health Science Center at Dallas, Southwestern Medical School, Dallas, Texas

Ben F. Dildy

Department of Pediatrics, The University of Texas Health Science Center at Dallas, Southwestern Medical School, Dallas, Texas

Francis Cope

Department of Pediatrics, The University of Texas Health Science Center at Dallas, Southwestern Medical School, Dallas, Texas

Teresa Zweighaft

Department of Pediatrics, The University of Texas Health Science Center at Dallas, Southwestern Medical School, Dallas, Texas

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 within 24 hours of initiating therapy. Reinfection with a new group A streptococcal serotype occurred in 13 patients, 12 developing 7 to 12 days afrer stopping therapy and 11 becoming symptomatic. Relapse with the same organism oc curred 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 re current 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%.

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