MANAGEMENT OF PEDIATRIC-PATIENTS WITH GROUP-A BETA-HEMOLYTIC STREPTOCOCCUS-PHARYNGITIS - TREATMENT OPTIONS

Pharyngitis caused by group A beta-hemolytic streptococci (GABHS) is one of the most common infections diagnosed in children, Orally administered penicillin is the standard treatment recommended for GABHS pharyngitis, but its use is compromised by the need for multiple daily doses and a relatively long (10 days) treatment regimen, Moreover, bacteriologic failures with penicillin treatment appear to be increasing, raising concerns about risk of sequelae and recurrence of symptomatic infection, Erythromycin, clindamycin and many cephalosporins are known to be safe and effective alternatives to penicillin for the treatment of pediatric patients with GABHS pharyngitis, Like penicillin, however, most of these agents require multiple daily doses for 10 days, making compliance difficult, The new azalide azithromycin has a markedly long half-life, allowing once daily administration for 5 days in the treatment of infections traditionally requiring a 10-day course of therapy with shorter acting drugs, Recent clinical trials have shown the suspension formulation of azithromycin to be safe and effective for treatment of children with GABHS pharyngitis, In these studies, azithromycin was statistically superior in both clinical outcome and bacteriologic eradication compared with penicillin, The abbreviated treatment course possible with this drug makes it a useful alternative for treatment of GABHS pharyngitis, particularly when compliance is a concern.