1097 THE EFFECTIVENESS OF TWICE DAILY PENICILLIN V (PENV) IN THE TREATMENT OF GROUP A BETA-HEMOLYTIC STREPTO-COCCAL (GABHS) PHARYNGITIS

Abstract

Most children with GABHS pharyngitis are treated with oral penicillin given either 3 or 4 times a day. In order to determine if a twice daily regimen would be as effective, 99 children with acute pharyngitis and a positive throat culture for GABHS were randomized to receive either 250 mg of penV t.i.d. or 250 mg of penV b.i.d. for 10 days. Compliance was checked by analyzing urine specimens for antimicrobial activity. Two weeks after completing therapy, patients returned for a follow-up throat culture. Acute and convalescent streptococcal serology were obtained on all patients. There was no difference between the two treatment groups with respect to age, sex, race, duration of illness prior to therapy, clinical findings, compliance, or percentage of children with an antibody rise. Nine of the 50 (18%) patients who received the t.i.d. regimen and 14 of the 49 (29%) patients who received the b.i.d. regimen had the same strain of GABHS (as determined by M- and T-typing) isolated from their follow-up as from their initial throat culture and were considered penicillin treatment failures (p>0.2). One of the 9 (22%) treatment failures in the t.i.d. group and 5 of the 14 (36%) treatment failures in the b.i.d. group were symptomatic at the time of their follow-up visits. Oral penV given twice a day appears as effective in the treatment of GABHS pharyngitis as penV given three times a day and is more convenient especially for children attending school.

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