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Once-daily amoxicillin dosing for streptococcal pharyngitis

American Family Physician, Sept 15, 1993

Although streptococcal pharyngitis is one of the most common conditions encountered in family practice, there is great variation in the management, of this condition. For approximately 40 years, the treatment of choice has been penicillin. In the search for alternative antibiotics, attention has focused on those with more convenient dosage schedules as well as improvement in ability to eliminate the infection. Shvartzman and colleagues studied the efficacy of once-daily amoxicillin treatment in patients who were attending five family medicine practices in Israel.

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The study included 157 patients with throat cultures positive for group A betahemolytic streptococci. Patients were randomly assigned to receive either phenoxymethylpenicillin, 250 mg three or four times daily, for 10 days (82 patients) or amoxicillin once daily for 10 days (75 patients). The dosage of amoxicillin was 50 mg per kg for children and 750 mg for adults. The two groups were comparable in demographic characteristics and in their clinical signs and symptoms. Compliance was assessed using telephone calls and follow-up visits.

No rashes or important side effects were noted in either group. Clinical response, as measured by persistence of symptoms such as fever, headache, sore throat and malaise, did not differ significantly between the two treatment groups. In addition, no differences were noted in time lost from school or work. Throat swabs, taken on the 14th day after the start of treatment, demonstrated a significantly greater bacteriologic clearance in the amoxicillin group. In that group, no positive cultures were found, compared with five (6 percent) in the group treated with penicillin.

The authors conclude that a single daily dose of amoxicillin is as effective as conventional treatment with penicillin in the management of streptococcal pharyngitis.

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Once-daily amoxicillin dosing for streptococcal pharyngitis

American Family Physician, Sept 15, 1993

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