Treatment of Streptococcal Pharyngitis With Once-Daily Amoxicillin Versus Intramuscular Benzathine Penicillin G in Low-Resource Settings: A Randomized Controlled Trial
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 enroll...
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| Veröffentlicht in: | Clinical pediatrics 2011-06, Vol.50 (6), p.535-542 |
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| creator | Rimoin, Anne W. Hoff, Nicole A. Fischer Walker, Christa L. Hamza, Hala S. Vince, Adriana Rahman, Naglaa Abdel Andrasevic, Sasa Emam, Soha Vukelic, Dubravka Elminawi, Nevine Ghafar, Hadeer Abdel da Cunha, Antonia L. A. Qazi, Shamim Gardovska, Dace Steinhoff, Mark C. |
| description | 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. |
| doi_str_mv | 10.1177/0009922810394838 |
| format | Article |
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A. ; Qazi, Shamim ; Gardovska, Dace ; Steinhoff, Mark C.</creator><creatorcontrib>Rimoin, Anne W. ; Hoff, Nicole A. ; Fischer Walker, Christa L. ; Hamza, Hala S. ; Vince, Adriana ; Rahman, Naglaa Abdel ; Andrasevic, Sasa ; Emam, Soha ; Vukelic, Dubravka ; Elminawi, Nevine ; Ghafar, Hadeer Abdel ; da Cunha, Antonia L. A. ; Qazi, Shamim ; Gardovska, Dace ; Steinhoff, Mark C.</creatorcontrib><description>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.</description><identifier>ISSN: 0009-9228</identifier><identifier>EISSN: 1938-2707</identifier><identifier>DOI: 10.1177/0009922810394838</identifier><identifier>PMID: 21317198</identifier><identifier>CODEN: CPEDAM</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Administration, Oral ; Amoxicillin - administration & dosage ; Anti-Bacterial Agents - administration & dosage ; Antibiotics ; Child ; Child, Preschool ; Clinical trials ; Croatia ; Disease prevention ; Egypt ; Female ; Humans ; Inflammatory diseases ; Injections, Intramuscular ; Male ; Pharyngitis - drug therapy ; Pharyngitis - microbiology ; Rheumatic fever ; Streptococcal Infections - diagnosis ; Streptococcal Infections - drug therapy ; Streptococcus ; Streptococcus pyogenes - drug effects ; Streptococcus pyogenes - isolation & purification ; Throat ; Treatment Outcome</subject><ispartof>Clinical pediatrics, 2011-06, Vol.50 (6), p.535-542</ispartof><rights>The Author(s) 2011</rights><rights>Copyright Westminster Publications, Inc. Jun 2011</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c492t-54de98744e529124cb80a42b7befad631afa13c81c0a7b02a9248a503e7c943</citedby><cites>FETCH-LOGICAL-c492t-54de98744e529124cb80a42b7befad631afa13c81c0a7b02a9248a503e7c943</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/0009922810394838$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/0009922810394838$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>230,314,780,784,885,21819,27924,27925,43621,43622</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21317198$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rimoin, Anne W.</creatorcontrib><creatorcontrib>Hoff, Nicole A.</creatorcontrib><creatorcontrib>Fischer Walker, Christa L.</creatorcontrib><creatorcontrib>Hamza, Hala S.</creatorcontrib><creatorcontrib>Vince, Adriana</creatorcontrib><creatorcontrib>Rahman, Naglaa Abdel</creatorcontrib><creatorcontrib>Andrasevic, Sasa</creatorcontrib><creatorcontrib>Emam, Soha</creatorcontrib><creatorcontrib>Vukelic, Dubravka</creatorcontrib><creatorcontrib>Elminawi, Nevine</creatorcontrib><creatorcontrib>Ghafar, Hadeer Abdel</creatorcontrib><creatorcontrib>da Cunha, Antonia L. A.</creatorcontrib><creatorcontrib>Qazi, Shamim</creatorcontrib><creatorcontrib>Gardovska, Dace</creatorcontrib><creatorcontrib>Steinhoff, Mark C.</creatorcontrib><title>Treatment of Streptococcal Pharyngitis With Once-Daily Amoxicillin Versus Intramuscular Benzathine Penicillin G in Low-Resource Settings: A Randomized Controlled Trial</title><title>Clinical pediatrics</title><addtitle>Clin Pediatr (Phila)</addtitle><description>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.</description><subject>Administration, Oral</subject><subject>Amoxicillin - administration & dosage</subject><subject>Anti-Bacterial Agents - administration & dosage</subject><subject>Antibiotics</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Clinical trials</subject><subject>Croatia</subject><subject>Disease prevention</subject><subject>Egypt</subject><subject>Female</subject><subject>Humans</subject><subject>Inflammatory diseases</subject><subject>Injections, Intramuscular</subject><subject>Male</subject><subject>Pharyngitis - drug therapy</subject><subject>Pharyngitis - microbiology</subject><subject>Rheumatic fever</subject><subject>Streptococcal Infections - diagnosis</subject><subject>Streptococcal Infections - drug therapy</subject><subject>Streptococcus</subject><subject>Streptococcus pyogenes - drug effects</subject><subject>Streptococcus pyogenes - isolation & purification</subject><subject>Throat</subject><subject>Treatment Outcome</subject><issn>0009-9228</issn><issn>1938-2707</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFksGPEyEUxonRuLV692SIF0-jMDADeDCpVddNmuxm2-hxQulry4aBLjDq7j_kvylNd1fdxHgBku_3PngfD6HnlLymVIg3hBCl6lpSwhSXTD5AI6qYrGpBxEM02svVXj9CT1K6IIQy0rDH6KimjAqq5Aj9XETQuQefcVjjeY6wy8EEY7TDZ1sdr_zGZpvwV5u3-NQbqD5o667wpA8_rLHOWY-_QExDwic-R90PyQxOR_we_LXOW-sBn4G_RY9xWWbhe3UOKQzRAJ5DztZv0ls8wefar0Jvr2GFp6G4BefKcRGtdk_Ro7V2CZ7d7GM0__RxMf1czU6PT6aTWWW4qnPV8BUoKTiHpla05mYpieb1UixhrVcto3qtKTOSGqLFktRa1VzqhjAQRnE2Ru8Orrth2cPKwL4l1-2i7UsUXdC2-1vxdtttwreuJVI1vC0Gr24MYrgcIOWut8mAc9pDGFKniKBtWwv-X1K2bcNYy0ghX94jL0p0vqTQSUFaJnn5-jEiB8jEkFKE9d2jKen2s9Ldn5VS8uLPZu8KboejANUBSHoDvy_9p-EvFP3J_w</recordid><startdate>20110601</startdate><enddate>20110601</enddate><creator>Rimoin, Anne W.</creator><creator>Hoff, Nicole A.</creator><creator>Fischer Walker, Christa L.</creator><creator>Hamza, Hala S.</creator><creator>Vince, Adriana</creator><creator>Rahman, Naglaa Abdel</creator><creator>Andrasevic, Sasa</creator><creator>Emam, Soha</creator><creator>Vukelic, Dubravka</creator><creator>Elminawi, Nevine</creator><creator>Ghafar, Hadeer Abdel</creator><creator>da Cunha, Antonia L. 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A.</au><au>Qazi, Shamim</au><au>Gardovska, Dace</au><au>Steinhoff, Mark C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Treatment of Streptococcal Pharyngitis With Once-Daily Amoxicillin Versus Intramuscular Benzathine Penicillin G in Low-Resource Settings: A Randomized Controlled Trial</atitle><jtitle>Clinical pediatrics</jtitle><addtitle>Clin Pediatr (Phila)</addtitle><date>2011-06-01</date><risdate>2011</risdate><volume>50</volume><issue>6</issue><spage>535</spage><epage>542</epage><pages>535-542</pages><issn>0009-9228</issn><eissn>1938-2707</eissn><coden>CPEDAM</coden><abstract>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.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>21317198</pmid><doi>10.1177/0009922810394838</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Clinical pediatrics, 2011-06, Vol.50 (6), p.535-542 |
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| subjects | Administration, Oral Amoxicillin - administration & dosage Anti-Bacterial Agents - administration & dosage Antibiotics Child Child, Preschool Clinical trials Croatia Disease prevention Egypt Female Humans Inflammatory diseases Injections, Intramuscular Male Pharyngitis - drug therapy Pharyngitis - microbiology Rheumatic fever Streptococcal Infections - diagnosis Streptococcal Infections - drug therapy Streptococcus Streptococcus pyogenes - drug effects Streptococcus pyogenes - isolation & purification Throat Treatment Outcome |
| title | Treatment of Streptococcal Pharyngitis With Once-Daily Amoxicillin Versus Intramuscular Benzathine Penicillin G in Low-Resource Settings: A Randomized Controlled Trial |
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