Seasonal benzathine penicillin G prophylaxis for recurrent streptococcal pharyngitis in children.

BACKGROUND

To assess the efficacy of benzathine penicillin G (BPG) prophylaxis in recurrent streptococcal pharyngitis in children.

METHODS

One hundred and sixty children, aged 4-11 years, who experienced at least two episodes of group A beta-hemolytic streptococcal (GABHS) pharyngitis during a 4-month observation period between September and December 1995 were randomly divided into two groups. During the following 4-month period between January and April 1996, 80 children received BPG prophylaxis every 3 weeks as a single intramuscular injection of 1.2 million units for a body weight greater than 27 kg and a half dose for 27 kg or less. Eighty children were accepted as a control group and were not given BPG prophylaxis.

RESULTS

The children in the BPG group experienced significantly less GABHS pharyngitis than those in the control group during the second 4-month period (16 vs 244 episodes, respectively, P < 0.001). BPG prophylaxis decreased streptococcal pharyngitis by 92% in the children in the study group, while the frequency of GABHS pharyngitis was unchanged in those in the control group during the second 4-month period compared with the first 4-month period.

CONCLUSIONS

The data in the present study demonstrated that intramuscular BPG prophylaxis is very effective in preventing GABHS pharyngitis in children. It is recommended that it is used every 3 weeks in at least the fall-winter seasons in children susceptible to frequent GABHS pharyngitis.