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Randomized Controlled Trial
. 2011 Jun;50(6):535-42.
doi: 10.1177/0009922810394838. Epub 2011 Feb 11.

Treatment of streptococcal pharyngitis with once-daily amoxicillin versus intramuscular benzathine penicillin G in low-resource settings: a randomized controlled trial

Anne W Rimoin  1 , Nicole A Hoff, Christa L Fischer Walker, Hala S Hamza, Adriana Vince, Naglaa Abdel Rahman, Sasa Andrasevic, Soha Emam, Dubravka Vukelic, Nevine Elminawi, Hadeer Abdel Ghafar, Antonia L A da Cunha, Shamim Qazi, Dace Gardovska, Mark C Steinhoff
Affiliations
Randomized Controlled Trial

Treatment of streptococcal pharyngitis with once-daily amoxicillin versus intramuscular benzathine penicillin G in low-resource settings: a randomized controlled trial

Anne W Rimoin et al. Clin Pediatr (Phila). 2011 Jun.

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.

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Conflict of interest statement

Declaration of Conflicting Interests

The author(s) declared no conflicts of interest with respect to the authorship and/or publication of this article.

Figures

Figure 1.
Figure 1.
Flow diagram of enrollment and inclusion into the Treatment of Pharyngitis Study (TOPS) trial (E, Egypt; C, Croatia)
See this image and copyright information in PMC

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