Evaluation of short-term clinical efficacy of 3-day therapy with azithromycin in comparison with 5-day cefcapene-pivoxyl for acute streptococcal tonsillopharyngitis in primary care

• Published in: Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 2011-08, Vol.17 (4), p.499-503
• Main Authors: Koga, Takeharu, Rikimaru, Toru, Tokunaga, Naoto, Higashi, Toshihiro, Matsuo, Kazuhiko, Nakamura, Masahiro, Ichikawa, Yoichiro
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Anti-Bacterial Agents - administration & dosage; Azithromycin; Azithromycin - administration & dosage; Cefcapene; Cephalosporins - administration & dosage; Chi-Square Distribution; Drug Administration Schedule; Efficacy; Female; Group A streptococcal tonsillopharyngitis; Hematology, Oncology and Palliative Medicine; Humans; Infectious Diseases; Male; Medical Microbiology; Medicine; Medicine & Public Health; Microbial Sensitivity Tests; Original Article; Pharyngitis - drug therapy; Pharyngitis - microbiology; Primary care; Prospective Studies; Streptococcal Infections - drug therapy; Streptococcal Infections - microbiology; Streptococcus; Streptococcus pyogenes - drug effects; Streptococcus pyogenes - isolation & purification; Tonsillitis - drug therapy; Tonsillitis - microbiology; Treatment Outcome; Virology; Young Adult
• ISSN: 1341-321X; 1437-7780
• DOI: 10.1007/s10156-010-0207-9

Abstract Group A streptococcal (GAS) tonsillopharyngitis is one of the few conditions for which antibiotics are advocated among common upper respiratory infections. Although a 3-day course of azithromycin is attracting attention as a treatment of choice for the condition, it is not clear if the efficacy of the treatment is comparable with that of treatment with cephalosporins. A prospective, randomized, comparative multicenter study was conducted to compare the efficacy of azithromycin (AZM) given once daily for 3 days with that of cefcapene-pivoxyl (CFPN-PI) divided into three daily doses for 5 days. 88 patients (male: 38, mean age: 16.5) were treated with AZM and 69 (male: 34, mean age: 16.9) with CFPN-PI. The symptoms of all but 5 (2 for AZM and 3 for CFPN-PI) of the patients were resolved by the 8th day of the treatment. By the 4th day of the treatment, criteria for clinical efficacy were fulfilled in 71 (80.7%) subjects who were treated with AZM and in 48 (67.6%) of those treated with CFPN-PI ( p = 0.07). The same figures on the 8th day of the treatment were 86 (97.7%) and 68 (95.8%), respectively ( p = 0.66), confirming there was no significant difference in clinical efficacy between the two treatments. Mild adverse reactions were reported by two patients treated with AZM and by none treated with CFPN-PI. The clinical efficacy of a 3-day course with AZM was comparable with that of a 5-day course of CFPN-PI for GAS tonsillopharyngitis.