Kikuta Hideaki, Shibata Mutsuo, Nakata Shuji, Yamanaka Tatsuru, Sakata Hiroshi, Akizawa Kouji, Kobayashi Kunihiko
Pediatric Clinic, Touei Hospital, N-41, E-16, Higashi-ku, Sapporo 007-0841, Japan.
Int J Pediatr. 2009;2009:863608. doi: 10.1155/2009/863608. Epub 2009 Mar 5.
Efficacy of short-course therapy with cephalosporins for treatment of group A beta-hemolytic streptococcus (GABHS) pharyngitis is still controversial. Subjects were 226 children with a history of at least one episode of GABHS pharyngitis. Recurrence within the follow-up period (3 weeks after initiation of therapy) occurred in 7 of the 77 children in the 5-day treatment group and in 1 of the 149 children in the 10-day treatment group; the incidence of recurrence being significantly higher in the 5-day treatment group. Bacteriologic treatment failure (GABHS isolation without overt pharyngitis) at follow-up culture was observed in 7 of the 77 children in the 5-day treatment group and 17 of the 149 children in the 10-day treatment group. There was no statistical difference between the two groups. A 5-day course of oral cephalosporins is not always recommended for treatment of GABHS pharyngitis in children who have repeated episodes of pharyngitis.
头孢菌素短程疗法治疗A组β溶血性链球菌(GABHS)咽炎的疗效仍存在争议。研究对象为226名有至少一次GABHS咽炎发作史的儿童。在5天治疗组的77名儿童中,有7名在随访期(治疗开始后3周)内复发;在10天治疗组的149名儿童中,有1名复发;5天治疗组的复发率明显更高。在5天治疗组的77名儿童中,有7名在随访培养时出现细菌学治疗失败(分离出GABHS但无明显咽炎);在10天治疗组的149名儿童中,有17名出现细菌学治疗失败。两组之间无统计学差异。对于有反复咽炎发作的儿童,不总是推荐使用5天疗程的口服头孢菌素治疗GABHS咽炎。