TY - JOUR
T1 - Treatment of streptococcal pharyngitis with once-daily amoxicillin versus intramuscular benzathine penicillin g in low-resource settings
T2 - A randomized controlled trial
AU - Rimoin, Anne W.
AU - Hoff, Nicole A.
AU - Fischer Walker, Christa L.
AU - Hamza, Hala S.
AU - Vince, Adriana
AU - Rahman, Naglaa Abdel
AU - Andrasevic, Sasa
AU - Emam, Soha
AU - Vukelic, Dubravka
AU - Elminawi, Nevine
AU - Ghafar, Hadeer Abdel
AU - Da Cunha, Antonia L.A.
AU - Qazi, Shamim
AU - Gardovska, Dace
AU - Steinhoff, Mark C.
PY - 2011/6
Y1 - 2011/6
N2 - Background: Primary prevention of acute rheumatic fever is achieved by proper antibiotic treatment of group A β -hemolytic streptococcal (GAS) pharyngitis. Methods: To assess noninferiority of oral amoxicillin to intramuscular benzathine penicillin G (IM BPG). Children (2 to 12 years) meeting enrollment criteria were randomized 1:1 to receive antibiotic treatment in 2 urban outpatient clinics in Egypt and Croatia. Results: A total of 558 children (Croatia = 166, Egypt = 392) were randomized, with 368 evaluable in an intention-to-treat (ITT) analysis, and 272 evaluable in the per protocol (PP) analysis. In Croatia, ITT and PP treatment success rates were comparable for IM BPG and amoxicillin (2.5% difference vs 1.1% difference, respectively). In Egypt, amoxicillin was not comparable with IM BPG in ITT analysis (15.1% difference), but was comparable in PP analysis (-9.3% difference). Conclusion: If compliance is a major issue, a single dose of IM BPG may be preferable for treatment of GAS pharyngitis.
AB - Background: Primary prevention of acute rheumatic fever is achieved by proper antibiotic treatment of group A β -hemolytic streptococcal (GAS) pharyngitis. Methods: To assess noninferiority of oral amoxicillin to intramuscular benzathine penicillin G (IM BPG). Children (2 to 12 years) meeting enrollment criteria were randomized 1:1 to receive antibiotic treatment in 2 urban outpatient clinics in Egypt and Croatia. Results: A total of 558 children (Croatia = 166, Egypt = 392) were randomized, with 368 evaluable in an intention-to-treat (ITT) analysis, and 272 evaluable in the per protocol (PP) analysis. In Croatia, ITT and PP treatment success rates were comparable for IM BPG and amoxicillin (2.5% difference vs 1.1% difference, respectively). In Egypt, amoxicillin was not comparable with IM BPG in ITT analysis (15.1% difference), but was comparable in PP analysis (-9.3% difference). Conclusion: If compliance is a major issue, a single dose of IM BPG may be preferable for treatment of GAS pharyngitis.
KW - amoxicillin
KW - intramuscular benzathine penicillin G
KW - randomized clinical trial
KW - streptococcal pharyngitis
UR - https://www.scopus.com/pages/publications/79956100472
U2 - 10.1177/0009922810394838
DO - 10.1177/0009922810394838
M3 - Article
C2 - 21317198
AN - SCOPUS:79956100472
SN - 0009-9228
VL - 50
SP - 535
EP - 542
JO - Clinical Pediatrics
JF - Clinical Pediatrics
IS - 6
ER -