European Journal of Pediatrics

, Volume 161, Issue 7, pp 365–367 | Cite as

Variables influencing bacteriological outcome in patients with streptococcal tonsillopharyngitis treated with penicillin V

  • Philippe Ovetchkine
  • Corinne Levy
  • France de la Rocque
  • Michel Boucherat
  • Edouard Bingen
  • Robert Cohen
Original Paper

Abstract.

Despite the fact that group A streptococci (GAS) remain susceptible to penicillin V (pen V), an increasing rate of bacteriological treatment failures has occurred. A recent study has suggested that the major variables associated with pen V treatment failures were the number of days ill prior to initiation of treatment (<2 days) and age <6 years. In order to study the link between pen V treatment failures and individual variables, we reviewed the files of all children enrolled in four randomised multicentre trials of oral antibiotic therapy, carried out from 1993 to 1999. A standard protocol and follow-up examination were used in these four studies: cultures were obtained 4 days and 1 month after completion of treatment. Total DNA restriction fragment length polymorphism was used to compare pre- and post-treatment GAS isolates. We enrolled 1560 children aged 3 to 12 years, 685 received a 10 day pen V regimen (45 mg/kg per day divided into three doses/day), among them 536 were assessable for bacteriological efficacy at the first and second follow-up visit. We found the only variable associated with penicillin treatment failure was the age of the child when infected. The rate of failure was statistically more important for children younger than 6 years (35.5%, 95% CI 29.9–-41.1) than for older children (21.9%, 95% CI 16.9–26.9). Conclusion: in this study only young age (<6 years) increases penicillin V treatment failures for group A streptococcal tonsillopharyngitis. This may lead to different antibiotic regimens and follow-up modalities for these targeted patients.

Penicillin V Streptococcal tonsillopharyngitis 

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Copyright information

© Springer-Verlag 2002

Authors and Affiliations

  • Philippe Ovetchkine
    • 1
  • Corinne Levy
    • 2
  • France de la Rocque
    • 2
  • Michel Boucherat
    • 2
  • Edouard Bingen
    • 3
  • Robert Cohen
    • 1
  1. 1.Department of Paediatrics, Créteil Hospital, ParisFrance
  2. 2.Association Clinique et Thérapeutique Infantile du Val de Marne, Saint-Maur des FossésFrance
  3. 3.Department of Microbiology, Robert Debré Hospital, ParisFrance
  4. 4.ACTIV, 27 Rue d'Inkermann, 94 100 Saint Maur des FossésFrance

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