Clinical course of pharyngotonsillitis with group A streptococcus treated with different penicillin V strategies, divided in groups of Centor Score 3 and 4: a prospective study in primary care

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Clinical course of pharyngotonsillitis with group A streptococcus treated with different penicillin V strategies, divided in groups of Centor Score 3 and 4: a prospective study in primary care

Tell, David (författare): Linköpings universitet,Linköping University,Institutionen för hälsa, medicin och vård,Medicinska fakulteten,Futurum, Reg Jonkoping Cty, Sweden

Tyrstrup, Mia (författare): Lund University,Lunds universitet,Allmänmedicin och samhällsmedicin,Forskargrupper vid Lunds universitet,Family Medicine and Community Medicine,Lund University Research Groups,Lund Univ, Sweden

Edlund, C. (författare): Public Health Agency of Sweden

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Rystedt, Karin (författare): University of Gothenburg,Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa,CARe - Centrum för antibiotikaresistensforskning,Institute of Medicine, School of Public Health and Community Medicine,Centre for antibiotic resistance research, CARe,Sahlgrenska Academy,Univ Gothenburg, Sweden; Primary Hlth Care, Sweden; Univ Gothenburg, Sweden

Stahlgren, G. S. (författare): Public Health Agency of Sweden

Sundvall, Pär-Daniel (författare): University of Gothenburg,Gothenburg University,Göteborgs universitet,CARe - Centrum för antibiotikaresistensforskning,Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa,Centre for antibiotic resistance research, CARe,Institute of Medicine, School of Public Health and Community Medicine,Sahlgrenska Academy,Univ Gothenburg, Sweden; Primary Hlth Care, Sweden; Univ Gothenburg, Sweden

Hedin, Katarina (författare): Linköpings universitet,Linköping University,Lund University,Lunds universitet,Allmänmedicin och samhällsmedicin,Forskargrupper vid Lunds universitet,Family Medicine and Community Medicine,Lund University Research Groups,Region Jönköping County,Avdelningen för prevention, rehabilitering och nära vård,Medicinska fakulteten,Futurum, Reg Jonkoping Cty, Sweden; Lund Univ, Sweden

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2022-11-11
2022
Engelska.
Ingår i: BMC Infectious Diseases. - : Springer Science and Business Media LLC. - 1471-2334. ; 22:1

Relaterad länk:: http://dx.doi.org/10... (free); visa fler...; https://liu.diva-por... (primary) (Raw object); https://gup.ub.gu.se...; https://doi.org/10.1...; https://lup.lub.lu.s...; https://urn.kb.se/re...; visa färre...

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Abstract Ämnesord

Stäng

Background Sore throat is a common reason for prescribing antibiotics in primary care, and 10 days of treatment is recommended for patients with pharyngotonsillitis with group A streptococcus (GAS). Our group recently showed that penicillin V (PcV) four times daily for 5 days was non-inferior in clinical outcome to PcV three times daily for 10 days. This study compares duration, intensity of symptoms, and side effects in patients with a Centor Score (CS) of 3 or 4 respectively, after treatment with PcV for 5 or 10 days and evaluates whether all patients with pharyngotonsillitis with a CS of 3 or 4 should be treated for 5 days or if severity of symptoms or CS suggest a longer treatment period. Method Data on symptoms and recovery from patient diaries from 433 patients included in a RCT comparing PcV 800 mg x 4 for 5 days or PcV 1 g x 3 for 10 days was used. Patients six years and older with CS-3 or CS-4 and positive rapid antigen detection test for GAS-infection were grouped based on CS and randomized treatment. Comparisons for categorical variables were made with Pearson's chi-squared test or Fisher's exact test. Continuous variables were compared with the Mann-Whitney U test. Results Patients with CS-3 as well as patients with CS-4 who received PcV 800 mg x 4 for 5 days self-reported that they recovered earlier compared to patients with CS-3 or CS-4 who received treatment with PcV 1 g x 3 for 10 days. In addition, the throat pain as single symptom was relieved 1 day earlier in patients with CS-4 and 5 days of treatment compared to patients with CS-4 and 10 days of treatment. No differences in side effects between the groups were found. Conclusion Intense treatment with PcV four times a day for 5 days seems clinically beneficial and strengthens the suggestion that the 4-dose regimen with 800 mg PcV for 5 days may be the future treatment strategy for GAS positive pharyngotonsillitis irrespectively of CS-3 or CS-4. Trail registration ClinicalTrials.gov ID: NCT02712307 (3 April 2016).

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Infektionsmedicin (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Infectious Medicine (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Allmänmedicin (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- General Practice (hsv//eng)

Nyckelord

Pharyngotonsillitis
Centor Score 3 and 4
Phenoxymethylpenicillin
Primary care
pyogenes-emm-types
acute sore throat
noninvasive infections
children
epidemiology
trial
Infectious Diseases
Pharyngotonsillitis; Centor Score 3 and 4; Phenoxymethylpenicillin; Primary care

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Av författaren/redakt...: Tell, David; Tyrstrup, Mia; Edlund, C.; Rystedt, Karin; Stahlgren, G. S.; Sundvall, Pär-Da ...; visa fler...; Hedin, Katarina; visa färre...

Om ämnet

MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Infektionsmedici ...

MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Allmänmedicin

Artiklar i publikationen: BMC Infectious D ...

Av lärosätet: Göteborgs universitet; Lunds universitet; Linköpings universitet

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