Cephalosporins better for streptococcus infections in children
The Journal of Family Practice. 2004 July;53(7):522-530
July 1, 2004|Family Medicine
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- CLINICAL QUESTION: Does the treatment of children with streptococcal tonsillopharyngitis with a cephalosporin instead of a penicillin result in better bacteriologic or clinical cure?
- STUDY DESIGN: Meta-analysis (randomized controlled trials)
- SETTING: Various (meta-analysis)
- SYNOPSIS: The authors of this meta-analysis identified 35 studies comparing a cephalosporin with penicillin for 10 days in the treatment of children with group A beta-hemolytic streptococcal pharyngitis. The studies (in all languages) were identified through MEDLINE and EMBASE searches, reference lists of identified trials, and abstracts from the meetings of the Society for Pediatric Research and the Interscience Conference on Antimicrobial Agents and Chemotherapy.
BOTTOM LINE
Treating streptococcal tonsillopharyngitis in children with a cephalosporin instead of penicillin produces significantly more bacteriologic and clinical cures. One additional child will benefit for every 13 children treated with a cephalosporin rather than penicillin. Only the cephalosporins cefaclor (Ceclor) and loracarbef (Lorabid) did not show an advantage over penicillin. The effect of cephalosporin treatment on prevention of rheumatic heart disease is not known. (LOE=1a)
