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Diagnosis and treatment of acute pharyngitis—Is there any benefit on ten-day course of antibiotics?

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Abstract Introduction In group A streptococcal (GAS) pharyngitis, a ten-day course of amoxicillin is recommended. However, short-course treatments seem to be equally effective. The aim of this study was to… Click to show full abstract

Abstract Introduction In group A streptococcal (GAS) pharyngitis, a ten-day course of amoxicillin is recommended. However, short-course treatments seem to be equally effective. The aim of this study was to retrospectively evaluate and compare the outcome of patients treated with 7-day course and 10-day course of amoxicillin. Materials and methods Retrospective analysis of all GAS pharyngitis admitted to a pediatric emergency department in 2014. Demographic variables, the application and results of the rapid antigenic diagnostic test (RADT), treatment, complications and return in the next 30 days were analyzed. Two groups were defined for comparative analysis according to the duration of treatment with amoxicillin: A) short-course (up to 7 days) and B) long-course (10 days). Results Were included 989 GAS pharyngitis. The median age was 5.2 years, 50.1% male. Amoxicillin was the most prescribed antibiotic (94.9%) with a median duration of 7 days. 10-day course therapy was prescribed in 31.9% of the cases. There were no differences between short and long-course treatment groups regarding age (p = 0.600), gender (p = 0.429) and complications (p = 0.436). Considering the endpoint “return to the emergency department”, we concluded that up to 7 days of treatment was non-inferior to 10 days of treatment. Conclusion The most commonly prescribed antibiotic was amoxicillin, but a 10-day course was prescribed in few cases. In our analysis there seems to be no benefit with long-course treatments with amoxicillin in GAS pharyngitis.

Keywords: gas pharyngitis; course; treatment; day course

Journal Title: Anales De Pediatria
Year Published: 2017

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