Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0031350 (pharyngitis)
 2,405 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A meta-analysis was conducted to compare the efficacy and safety of oral cefadroxil monohydrate (30 mg/kg QD or 15 mg/kg BID) with that of oral penicillin V (8, 10, or 15 mg/kg BID, TID, or QID) in the treatment of group A beta-hemolytic streptococcal (GABHS) pharyngitis and tonsillitis treated for 10 days. A simple random effects model was used for combining the efficacy and safety results of nine comparative trials performed in the United States. A total of 1646 patients aged < or = 19 years were considered evaluable; 1406 patients were evaluable using revised bacteriologic criteria, and 1499 patients were considered fully evaluable for safety. The results demonstrate significantly better response rates (P < 0.05) with cefadroxil monohydrate than with penicillin V for overall cure (91.8% versus 81.3%), bacteriologic cure (92.6% versus 81.4%), and bacteriologic recurrence (4.2% versus 10.5%); clinical cure rates were statistically similar (90.5% versus 90.2%). Revised bacteriologic criteria analysis revealed bacteriologic cure rates of 95.8% versus 88.7% (P < 0.05) and bacteriologic recurrence rates of 4.9% versus 7.1% (P = NS) for cefadroxil monohydrate and penicillin V, respectively. Adverse events related to drug administration occurred infrequently and did not differ significantly between treatment groups (P > 0.05). Compliance with cefadroxil monohydrate was at least as good as with penicillin V. Penicillin is currently the drug of choice in the treatment of GABHS pharyngitis and tonsillitis. Based on the information described in this large meta-analysis, cefadroxil monohydrate is an excellent alternative to oral penicillin V in the treatment of GABHS pharyngitis and tonsillitis.
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PMID:Therapy for pharyngitis and tonsillitis caused by group A beta-hemolytic streptococci: a meta-analysis comparing the efficacy and safety of cefadroxil monohydrate versus oral penicillin V. 146 91

Loracarbef, a member of a unique class of beta-lactam compounds (carbacephems), has excellent chemical and beta-lactamase stability, as well as documented clinical effectiveness against a broad spectrum of bacteria. Ten-day treatment regimens of loracarbef (200-mg capsule BID or 15 mg/kg/day suspension) and penicillin VK (250-mg capsule QID or 20 mg/kg/day suspension) were compared in the treatment of group A beta-hemolytic streptococcal (GABHS) pharyngitis and tonsillitis. Adults (greater than or equal to 12 years of age) were administered loracarbef (n = 58) or penicillin (n = 58) in a double-blind, randomized, parallel study of clinical and bacteriologic response to treatment. Favorable clinical responses among qualified (evaluable) patients in the loracarbef-treated group (46/47; 97.9%) were similar to those for evaluable patients in the penicillin-treated group (43/43; 100%). Forty-one of 47 (87.2%) of the evaluable loracarbef-treated patients and 100% (43/43) of the evaluable penicillin-treated patients had negative posttherapy throat cultures for GABHS. Thirty-nine evaluable patients in each treatment group were assessed 28 to 35 days after completion of therapy: 2.6% of patients in each group experienced relapse of symptoms; and 7.7% of loracarbef-treated patients had positive cultures, compared to 12.8% of penicillin-treated patients. Two (1.9%) loracarbef-treated patients with rashes and one (0.9%) penicillin-treated patient with diarrhea withdrew from the study due to these adverse events. Diarrhea, the most frequently occurring adverse event during therapy in the loracarbef group, was reported by 8.6% of the loracarbef group and by 5.2% of the penicillin group. These data support the conclusion that loracarbef is comparable in safety and efficacy to penicillin VK for the treatment of streptococcal pharyngitis and tonsillitis in adults.
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PMID:Loracarbef versus penicillin VK in the treatment of streptococcal pharyngitis and tonsillitis in adults. 157 24

Noncompliance with therapeutic drug regimens is a public health problem with major health and economic implications. Reported rates of noncompliance for all types of drugs range from 13% to 93% among adults and from 25% to 82% among children. In recent years, sophisticated techniques for evaluating noncompliance have evolved, as has our understanding of factors associated with noncompliance. A key factor is the prescribed dosing schedule for a drug. Studies indicate that there is a direct relationship between frequency of dose and compliance. A study of compliance with short-term regimens of oral antibiotic therapy found mean compliance rates of 80%, 69%, and 38% for administration once a day (QD), twice a day (BID), and three times a day (TID), respectively. Pharmacoeconomic analyses of dose-related compliance have demonstrated that significant savings can be achieved with QD dosing of antihypertensive medication. Although similar analyses have not been performed for drug regimens used in the treatment of infectious diseases that are usually treated on an outpatient basis, it is probable that comparable savings will be attained when economic analyses of dose/compliance relationships in short-term antibiotic therapy for such common disorders as sinusitis, pharyngitis, otitis media, urinary tract infections, and community-acquired pneumonia are undertaken.
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PMID:Overview of issues related to medical compliance with implications for the outpatient management of infectious diseases. 786 59

In a double-blind, prospective, randomized, multicenter study, 164 patients with a clinical and bacteriologic diagnosis of acute streptococcal tonsillitis/pharyngitis were enrolled to compare the efficacy and safety of two regimens of clindamycin. A rapid identification test of Group A beta-hemolytic streptococci (GABHS) was used to initiate the therapy; however, a positive tonsillar/pharyngeal culture was required at pretreatment to determine if the patient was assessable. Another culture was repeated at least 2 days after the 10 days of drug therapy. From 164 patients enrolled (mean age, 27.7 years; range, 14 to 60 years), 141 were assessable for efficacy; 22 patients were excluded because they did not have a positive culture at pretreatment and 1 patient did not complete the study due to a side effect (rash). All patients were included in the safety analysis. Patients received either clindamycin hydrochloride capsules 150 mg four times per day (QID) or clindamycin hydrochloride capsules 300 mg two times per day (BID) and placebo capsules BID for 10 days. There were no significant differences between groups in terms of demographics, medical history, and evolution of symptoms. The clinical efficacy rate in the two groups at day 12 was as follows: QID group--cured, 64 (92.8%) of 69 patients; improved, 5 (7.2%) of 69 patients; BID group--cured, 67 (93.1%) of 72 patients; improved, 5 (6.9%) of 72 patients. There were no significant differences between the groups. Both regimens were well tolerated with only 1 patient in the QID group who did not complete the therapy due to a rash.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:A double-blind, multicenter comparative study of two regimens of clindamycin hydrochloride in the treatment of patients with acute streptococcal tonsillitis/pharyngitis. 856 25

This multicenter, randomized, controlled, investigator-masked study was performed to assess the efficacy and tolerability of cefdinir for the treatment of streptococcal pharyngitis. Children aged 1 through 12 years with signs and symptoms of pharyngitis and a positive result on a rapid screening test for Streptococcus pyogenes were randomly assigned to receive cefdinir 14 mg/kg QD, cefdinir 7 mg/kg BID, or penicillin V 10 mg/kg 4 times daily for 10 days. Seven hundred ninety-two patients were enrolled, and 682 were clinically and microbiologically assessable. All treatment groups had similar demographic characteristics (-50.0% male, predominantly white, median age 7 years). The eradication rates of S pyogenes, determined 4 to 9 days after completion of therapy, were 94.3% in the cefdinir QD group, 94.3% in the cefdinir BID group, and 70.0% in the penicillin V group (95% confidence interval [CI] 17.6%-30.9%, P < 0.001 for cefdinir QD vs penicillin; CI 17.5%-30.9%, P < 0.001 for cefdinir BID vs penicillin). Clinical cure rates were 97.4%, 96.0%, and 86.3% for the cefdinir QD, cefdinir BID, and penicillin groups, respectively (CI 6.1%-15.9%, P = 0.001 for cefdinir QD vs penicillin; CI 4.6%-14.8%, P = 0.001 for cefdinir BID vs penicillin). Adverse reactions occurred in 8.3%, 8.7%, and 7.6% of cefdinir QD, cefdinir BID, and penicillin patients, respectively (P = NS). Treatment with cefdinir, either QD or BID, was associated with higher eradication rates of S pyogenes and higher clinical cure rates. Both cefdinir and penicillin were well tolerated. Three patients, 1 receiving cefdinir BID and 2 receiving penicillin, discontinued the study drug because of adverse reactions.
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PMID:Comparison of cefdinir and penicillin for the treatment of pediatric streptococcal pharyngitis. 1050 47

Cefdinir, an oral cephalosporin active against Streptococcus pyogenes (group A beta-hemolytic streptococci [GABHS]), is also resistant to degradation by most oropharyngeal beta-lactamases. This multicenter, randomized, controlled, double-masked study assessed the tolerability and efficacy of 2 dosing regimens of cefdinir in the treatment of pharyngitis due to GABHS. Adults and adolescents with pharyngitis due to GABHS received cefdinir 600 mg QD, cefdinir 300 mg BID, or penicillin V 250 mg QID each for 10 days. A throat culture and clinical assessment were obtained 4 to 9 days after completion of therapy. Of 919 patients enrolled, 644 (70.1%) were microbiologically assessable. The eradication rates 4 to 9 days after completion of therapy were 91.4% in the cefdinir QD group, 91.7% in the cefdinir BID group, and 83.4% in the penicillin group (P = 0.02 for cefdinir QD vs penicillin, P = 0.01 for cefdinir BID vs penicillin, P = 0.95 for cefdinir QD vs cefdinir BID). Clinical cure rates were also superior with cefdinir QD (94.8%, P = 0.02) and cefdinir BID (96.3%, P < 0.01) compared with penicillin (88.9%). Diarrhea was more common in the cefdinir groups (P < 0.001). Seventeen cefdinir patients and 4 penicillin patients discontinued therapy because of adverse reaction (P = 0.13). Ten days of treatment for streptococcal pharyngitis with cefdinir QD or BID is superior to treatment with penicillin V for the eradication of GABHS from the pharynx, although it is associated with a higher rate of adverse reactions.
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PMID:Comparison of cefdinir and penicillin for the treatment of streptococcal pharyngitis. Cefdinir Pharyngitis Study Group. 1089 Feb 59