Efficacy of Short-course Therapy with the Ketolide Telithromycin Compared with 10 Days of Penicillin V for the Treatment of Pharyngitis/Tonsillitis

• Published in: Scandinavian journal of infectious diseases Vol. 33; no. 12; pp. 883 - 890
• Main Authors: NORRBY, S. Ragnar, RABIE, Willem J, BACART, Patrick, MUELLER, Otmar, LEROY, Bruno, RANGARAJU, Manickam, BUTTICAZ-IROUDAYASSAMY, Emmanuelle
• Format: Journal Article
• Language: English
• Published: Basingstoke Informa UK Ltd 2001; Taylor & Francis
• Subjects: Adolescent; Adult; Anti-Bacterial Agents - therapeutic use; Antibacterial agents; Antibiotics. Antiinfectious agents. Antiparasitic agents; Biological and medical sciences; Double-Blind Method; Europe; Female; Humans; Ketolides; Macrolides; Male; Medical sciences; Middle Aged; Penicillin V - therapeutic use; Penicillins - therapeutic use; Pharmacology. Drug treatments; Pharyngitis - drug therapy; Pharyngitis - microbiology; Streptococcal Infections - drug therapy; Streptococcus pyogenes; Tonsillitis - drug therapy; Tonsillitis - microbiology; Treatment Outcome; Treatment efficiency; β-Lactams; Telithromycin; Duration; Tonsillitis; Penicillin derivatives; Antibiotic; Chemotherapy; Treatment; ENT disease; Pharynx disease; Pharyngitis; Antibacterial agent; Comparative study; Phenoxymethylpenicillin
• ISSN: 0036-5548; 1651-1980
• DOI: 10.1080/00365540110077443

This randomized, double-blind study compared the efficacy and safety of a 5-d course of the new ketolide antimicrobial, telithromycin, with those of a standard 10-d course of penicillin V (phenoxymethylpenicillin) in patients with group A -hemolytic streptococci (GABHS) pharyngitis/tonsillitis. Patients aged 15-65 y (n = 395) with clinical signs and symptoms of pharyngitis/tonsillitis and a positive streptococcal antigen test or throat culture for GABHS were randomized to receive either telithromycin 800 mg once daily for 5 d (n =198) or penicillin V 500 mg three times daily for 10 d (n = 197). Clinical and bacteriologic outcomes were assessed at post-therapy, test-of-cure (Days 16-20) and late post-therapy (Days 38-45) visits. Telithromycin for 5 d was equivalent to 10 d of penicillin V in terms of bacteriologic and clinical outcome (per-protocol): at post-therapy, test-of-cure visit, bacteriologic outcome was satisfactory in 84.3% and 89.1% of patients in the telithromycin and penicillin V groups, respectively, while clinical cure was achieved in 94.8% and 94.1% of patients, respectively. At late post-therapy, 82.4% of patients treated with telithromycin achieved a satisfactory bacteriologic outcome, compared with 84.7% of penicillin V recipients. The GABHS eradication rates for telithromycin and penicillin post-therapy were 85.2% and 89.1%, respectively, and 86.1% and 86.5%, respectively at late post-therapy. Both treatments were well tolerated, with a similar overall incidence of treatment-emergent adverse events. Short-course (5 d) therapy with telithromycin 800 mg once daily is comparable to a standard 10 d course of penicillin V for the treatment of GABHS pharyngitis/tonsillitis in adults and adolescents.