Macrolides for streptococcal pharyngitis in children. Five-day spiramycin treatment

An open-label, randomized study was conducted in 298 children older than 18 months (211 evalualbe) to compare seven days of penicillin V with five days of spiramycin for the treatment of pharyngitis due to group A streptococcus. There were no significant differences between study populations. Clinical and bacteriological results were similar in the two groups, even for the intention-to-treat analysis. Safety was also similar, as well as relapse rates, reinfection rates, and proportions of asymptomatic carriers on D10 and D30. These data demonstrate that five-day-twice-daily treatment with spiramycin is effective in streptococcal pharyngitis and may be a good alternative in patients with contraindications to beta-lactams.