Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0040425 (tonsillitis)
 1,594 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Cefuroxime axetil (CAE), an orally absorbed prodrug of cefuroxime, was evaluated for its efficacy and safety in the treatment of upper respiratory tract infections (tonsillitis, pharyngitis, sinusitis and otitis media) in general practice in the United Kingdom. A total of 385 patients aged 14 or over were enrolled in a randomized study to compare cefuroxime axetil 250 mg b.d. for 5 days with amoxycillin/clavulanate (Augmentin, AUG) 375 mg t.d.s. for 5 days. Of 175 clinically assessable patients treated with cefuroxime axetil, 136 were cured and 33 improved (97% success rate). Of 188 assessable patients given Augmentin, 155 were cured and 29 improved (98% success rate). Sixty-four patients treated with cefuroxime axetil were evaluable for bacteriological response: 47 (73%) of the causative pathogens were eradicated, as compared with 62 of 86 (72%) in patients treated with Augmentin. Thirteen out of 181 (7%) patients treated with cefuroxime axetil experienced drug-related adverse events, including 4% with diarrhoea. In the Augmentin group 24 out of 204 (12%) patients had a drug-related adverse event, including 5% with diarrhoea. In conclusion, cefuroxime axetil at a dose of 250 mg b.d. appears to be as safe and effective as Augmentin at the higher dose of 375 mg t.d.s. in the treatment of upper respiratory tract infections.
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PMID:A comparison of the efficacy and safety of cefuroxime axetil and augmentin in the treatment of upper respiratory tract infections. 358 35

Recent resurgence in serious streptococcal infections and rising failure rates with the standard 10-day course of therapy with penicillin V for group A beta-haemolytic streptococcus (GABHS)-associated tonsillopharyngitis (pharyngitis and/or tonsillitis) have heightened interest in alternative treatments for this infection. Reasons for failure of the standard therapy include penicillin tolerance, increased virulence of GABHS strains, inactivation by beta-lactamase, and poor compliance. Short, 4-5-day courses with oral cephalosporins, such as cefuroxime axetil, have recently proven to be effective alternatives. Cefuroxime axetil provides resolution of clinical symptoms and fever within 2.5 days of onset of therapy, and its short course of treatment may improve compliance.
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PMID:Tonsillopharyngitis: evaluation of short-term treatment with cefuroxime axetil versus standard 10-day penicillin V therapy. 774 80

The efficacy of cefuroxime axetil compared with phenoxymethylpenicillin (PcV) was studied in group A beta-haemolytic streptococci (GAS) culture-proven tonsillitis in children aged 3-12 years with a history of at least 1 episode of tonsillopharyngitis requiring antibiotic therapy during the previous 3 months. This was a comparative, randomized, investigator-blind, multicentre study. A total of 236 children received either cefuroxime axetil suspension or PcV syrup. Inclusion criteria were a positive, rapid, group A strep test verified by bacteriological culture and clinical signs and symptoms of tonsillopharyngitis. Cefuroxime axetil treatment gave a significantly higher bacteriological eradication rate and clinical cure rate than PcV. At day 2-5 post treatment the eradication rates were 99/114 (87%) for cefuroxime axetil vs 61/109 (56%) for PcV (p < 0.001). The clinical cure rates were 98/114 (86%) and 73/109 (67%) respectively (p < 0.01). Up to 21-28 days post-treatment, 9/114 (8%) cefuroxime axetil patients and 37/109 (34%) PcV patients were treatment failures or had recurrence/reinfection of GAS tonsillopharyngitis (p < 0.001). More than 90% of the patients who experienced bacteriological treatment failure at either the first or second follow-up had the same serotype isolated pre- and post-treatment. During the study period, 21/114 (18%) patients in the cefuroxime axetil group and 50/109 (46%) patients in the PcV group received additional antibiotics (p < 0.001). No serious adverse events were noted and the mild adverse events were equally distributed among the patients in the 2 study groups: 15% for cefuroxime axetil and 14% for PcV.
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PMID:Is penicillin the appropriate treatment for recurrent tonsillopharyngitis? Results from a comparative randomized blind study of cefuroxime axetil and phenoxymethylpenicillin in children. The Swedish Study Group. 853 45

Cefuroxime is the first commercially-available second-generation cephalosporine to be widely used in therapy; it is a semi-synthetic cephalosporin obtained from the 7-cephalosporanic acid nucleus of cephalosporin C. Cefuroxime axetil is the acetoxyethyl ester of cefuroxime. The majority of micro-organisms associated with respiratory infections are highly sensitive to cefuroxime. These include Haemophilus influenzae, Streptococcus pneumoniae, Streptococcus pyogenes and the other streptococci (excluding group D streptococci), and Moraxella catarrhalis. Bacteria sensitive to cefuroxime include the enterobacteria (Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, and Salmonella and Shigella and Straphylococcus aureus (methicillin-sensitive strains). The pharmacokinetic studies show that the maximum plasma concentration of cefuroxime after oral administration of 250 mg and 500 mg of cefuroxime axetil after a meal are respectively 4.6 and 7.9 mg/l. The absolute bioavailability of tablets is 68% (extremes 63-73%) after oral administration of 500 mg cefuroxime axetil. The protein binding is 33+/-5.7%. Tissue diffusion was studied in the interstitial fluid, the bronchial mucosa, the tonsils, and the bronchial secretions. Cefuroxime axetil is available as capsule-shaped tablets containing 125, 250 or 500 mg. An oral suspension dosage form for paediatric purposes is also available as granules in multidose bottles and sachets. Constitution gives a suspension containing 125 mg or 250 mg cefuroxime (as cefuroxime axetil). Cefuroxime axetil is indicated for the treatment of infections caused by susceptible bacteria. Indications include: lower respiratory tract infections (e.g., acute and chronic bronchitis and pneumonia); upper respiratory tract infections (e.g., ear, nose and throat infections such as otitis media, sinusitis tonsillitis and pharyngitis); genito-urinary tract infections (e.g., pyelonephritis, cystitis and urethritis, gonorrhoea, acute uncomplicated gonococcal urethritis and cervicitis); and skin and soft tissue infections (e.g., furunculosis, pyoderma and impetigo). For most infections, a dose of 250 mg twice daily is appropriate. In some urinary tract infections, 125 mg twice daily has been shown to be effective. If pneumonia is suspected or in more severe lower respiratory tract infection, doses of 500 mg bd should be used. Uncomplicated gonorrhoea has been shown to respond to a single 1-g dose of cefuroxime axetil. Adverse reactions to cefuroxime have generally been mild and transient in nature (gastrointestinal disturbances, including diarrhoea, nausea and vomiting).
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PMID:Cefuroxime axetil. 1861 87