Journal Article

Macrolide Therapy of Group A Streptococcal Pharyngitis: 10 Days of Macrolide Therapy (Clarithromycin) Is More Effective in Streptococcal Eradication than 5 Days (Azithromycin)

Edward L. Kaplan, W. Manfred Gooch, Gerard F. Notario and J. Carl Craft

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 32, issue 12, pages 1798-1802
Published in print June 2001 | ISSN: 1058-4838
Published online June 2001 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/320745
Macrolide Therapy of Group A Streptococcal Pharyngitis: 10 Days of Macrolide Therapy (Clarithromycin) Is More Effective in Streptococcal Eradication than 5 Days (Azithromycin)

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We compared recommended doses of 2 oral macrolide antibiotics (10 days of clarithromycin, 5 days of azithromycin) for eradicating group A streptococci from the throats of individuals aged ⩾12 years with symptomatic pharyngitis and a positive throat culture. Patients received either clarithromycin (250 mg b.i.d. for 10 days [n = 260]) or azythromycin (500 mg on day 1, followed by 250 mg q.d. for 4 days [n = 265]). Follow-up throat cultures were obtained both at 13–19 days and at 28–38 days. We evaluated 392 patients (median age, 26 years; clarithromycin, 194 patients; azyithromycin, 198 patients). Ten days of clarithromycin therapy was more effective than 5 days of azithromycin therapy in eradicating the organism (91% [176/194] vs. 82% [162/198]; P = .012). More than 97% of all streptococcal isolates were macrolide-sensitive. Whether these bacteriologic eradication rates were the result of the 2 macrolides compared or were due to differences in duration of therapy could not be determined, but the statistically significant difference in eradication of group A streptococci does raise additional questions about shortened courses of macrolide therapy for this common infection.

Journal Article.  3193 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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