Asakura Medical Association Hospital, 422-1 Raiharu, Asakura, 838-0069, Japan.
J Infect Chemother. 2011 Aug;17(4):499-503. doi: 10.1007/s10156-010-0207-9. Epub 2011 Jan 21.
Group A streptococcal (GAS) tonsillopharyngitis is one of the few conditions for which antibiotics are advocated among common upper respiratory infections. Although a 3-day course of azithromycin is attracting attention as a treatment of choice for the condition, it is not clear if the efficacy of the treatment is comparable with that of treatment with cephalosporins. A prospective, randomized, comparative multicenter study was conducted to compare the efficacy of azithromycin (AZM) given once daily for 3 days with that of cefcapene-pivoxyl (CFPN-PI) divided into three daily doses for 5 days. 88 patients (male: 38, mean age: 16.5) were treated with AZM and 69 (male: 34, mean age: 16.9) with CFPN-PI. The symptoms of all but 5 (2 for AZM and 3 for CFPN-PI) of the patients were resolved by the 8th day of the treatment. By the 4th day of the treatment, criteria for clinical efficacy were fulfilled in 71 (80.7%) subjects who were treated with AZM and in 48 (67.6%) of those treated with CFPN-PI (p = 0.07). The same figures on the 8th day of the treatment were 86 (97.7%) and 68 (95.8%), respectively (p = 0.66), confirming there was no significant difference in clinical efficacy between the two treatments. Mild adverse reactions were reported by two patients treated with AZM and by none treated with CFPN-PI. The clinical efficacy of a 3-day course with AZM was comparable with that of a 5-day course of CFPN-PI for GAS tonsillopharyngitis.
A 组链球菌（GAS）扁桃体咽炎是少数几种推荐使用抗生素治疗的常见上呼吸道感染之一。虽然阿奇霉素（AZM）3 天疗程作为该病的首选治疗方法引起了关注，但尚不清楚该治疗的疗效是否与头孢菌素相当。进行了一项前瞻性、随机、对照的多中心研究，比较了每日 1 次连续 3 天给予 AZM 与每日 3 次连续 5 天给予头孢卡品匹肟（CFPN-PI）的疗效。88 例患者（男性 38 例，平均年龄 16.5 岁）接受 AZM 治疗，69 例（男性 34 例，平均年龄 16.9 岁）接受 CFPN-PI 治疗。除 5 例（AZM 2 例，CFPN-PI 3 例）患者外，所有患者的症状均在治疗第 8 天缓解。治疗第 4 天，AZM 治疗的 71 例（80.7%）和 CFPN-PI 治疗的 48 例（67.6%）患者符合临床疗效标准（p=0.07）。治疗第 8 天的相同数据分别为 86 例（97.7%）和 68 例（95.8%）（p=0.66），证实两种治疗方法的临床疗效无显著差异。AZM 治疗的 2 例患者和 CFPN-PI 治疗的患者中均有轻度不良反应报告。AZM 3 天疗程的临床疗效与 CFPN-PI 5 天疗程相当。
