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Clinical Pediatrics
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*AMOXICILLIN
*CEPHALEXIN
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*Sore Throat
*Streptococcal Infections
*Tonsils and Adenoids
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Symptomatic Relapse of Group A ß-Hemolytic Streptococcal Tonsillopharyngitis in Children

Janet R. Casey, MD

University of Rochester School of Medicine, Elmwood Pediatric Group, Rochester, New York, jrcasey{at}rochester.rr.com

Michael E. Pichichero, MD

University of Rochester School of Medicine, Elmwood Pediatric Group, Rochester, New York

The frequency of symptomatic relapses following various antibiotic treatments for group A ß-hemolytic streptococcal tonsillopharyngitis was evaluated in 1080 pediatric patients. Within 5 days of completing therapy, the rank-order frequency of treatment failures was (1) penicillin, (2) amoxicillin, (3) first-generation cephalosporins, (4) ß-lactamase stable cephalosporins and amoxicillin-clavulanate ( P = .005). Retreatment of symptomatic failures resulted in another symptomatic relapse more often with penicillin than with cephalosporins (P = .02). Clinicians should be aware that the rate of symptomatic failures after antibiotic therapy for group A ß-hemolytic streptococcal tonsillopharyngitis differs by drug and is not an uncommon event.

Key Words: streptococcal tonsillopharyngitis • treatment • failures

Clinical Pediatrics, Vol. 46, No. 4, 307-310 (2007)
DOI: 10.1177/0009922806293919
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J. R. Casey, R. Kahn, D. Gmoser, E. Atlas, K. Urbani, S. Luber, H. Pellman, and M. E. Pichichero
Frequency of Symptomatic Relapses of Group A {beta}-Hemolytic Streptococcal Tonsillopharyngitis in Children From 4 Pediatric Practices Following Penicillin, Amoxicillin, and Cephalosporin Antibiotic Treatment
Clinical Pediatrics, July 1, 2008; 47(6): 549 - 554.
[Abstract] [PDF]