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Penicillin, amoxicillin: Step aside for strep throat treatment

Doctors today presented more evidence that it's time for long-time antibiotic stalwarts like penicillin and amoxicillin to step aside when it comes to the treatment of strep throat.

The most common medications used to treat the strep germ, the bug that causes millions of sore throats in U.S. children every year, simply aren't doing the job and aren't as effective as newer antibiotics known as cephalosporins. In results presented today at a large infectious disease meeting, the annual Interscience Conference on Antimicrobial Agents and Chemotherapy in Washington, doctors who reviewed the treatment given to 11,426 children showed that even a short course of the newer drugs is more effective than the traditional 10-day dose of the older antibiotics.

Pediatricians at the University of Rochester Medical Center found that 25 percent of children treated for strep throat with penicillin ended up back in the doctor's office within three weeks of treatment. Children treated with amoxicillin returned 18 percent of the time. The numbers were 14 percent for older-generation cephalosporins, and just 7 percent for newer ones like cefpodoxime and cefdinir, which are given for just four or five days.

The new results buttress previous work by physicians Michael Pichichero, M.D., and Janet Casey, M.D., showing that more children who receive the older drugs relapse, prolonging their illness and forcing doctors to turn to even stronger drugs. Yet, said Pichichero, doctors across the land continue to prescribe ineffective medications. Studies have shown that approximately 60 to 80 percent of children treated for strep are prescribed amoxicillin; 10 to 20 percent are prescribed penicillin; and just 10 to 20 percent receive a cephalosporin.

"Most doctors are shocked to learn of the high failure rates of the older medications," said Pichichero, a professor of Microbiology and Immunology.

"The treatment paradigm for treating strep sore throats has been
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Source:University of Rochester Medical Center


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