This site is intended for health professionals only

At the heart of general practice since 1960

Strep throat drugs queried

Penicillin and amoxicillin often fail to treat strep throat and should be retired as first-line treatments, researchers on a new meta-analysis conclude.

The analysis of US and European strep throat trials found 25 per cent of children receiving penicillin and 18 per cent on amoxicillin had to return to their doctor within three weeks.

By contrast, only 7 per cent of children treated with new-generation cephalosporins such as cefpodoxime had to see their doctor again in the time period.

Study leader Professor Mich-ael Pichichero, professor of microbiology and immunology at the University of Rochester in the US, said the data called for the new cephalosporins to be routinely used first-line.

He said: 'Most doctors are shocked to learn of the high failure rates of the older medications. The paradigm for treating strep sore throats has been changing slowly and endorsing use of cephalosporins as a first-line treatment is something that needs to be seriously considered.'

The study of 11,426 children on 47 trials, presented to December's Interscience Conference on Antimicrobial Agents and Chemotherapy in Washington, found cephalosporins produced consistently superior cure rates. They were more than four times better than penicillin in 10-day European trials.

But UK experts were cautious about backing a move away from penicillin, with concerns over resistance and the successful identification of streptococcus bacteria.

Dr Anthony Harnden, senior lecturer at the department of primary health care, University of Oxford, and a GP in Wheatley, Oxfordshire, said: 'I'd like to see, before you argue a different antibiotic is required, that they could demonstrate any penicillin resistance among group A streptococcal. I think there's hardly any.'

Dr Robert George, consultant medical microbiologist at the Health Protection Agency, said: 'The World Health Organisation continues to recommend penicillin as first-line treatment for strep throat and the HPA guidance is in accordance.'

Rate this article 

Click to rate

  • 1 star out of 5
  • 2 stars out of 5
  • 3 stars out of 5
  • 4 stars out of 5
  • 5 stars out of 5

0 out of 5 stars

Have your say