A comparative study of clarithromycin and penicillin VK in the treatment of outpatients with streptococcal pharyngitis

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Abstract
This double-blind, randomized 17-centre clinical trial compared the safety and efficacy of clarithromycin (2 × l25mg capsules) 12-hourly and penicillin VK (2 × l25mg tablets in capsules) 6-hourly in the treatment of proven Group A, β haemolytic streptococcal pharyngitis. One hundred and twenty-eight patients (clarithromycin: 65, penicillin VK: 63) were enrolled in the study and included in the safety analysis. Clinical and bacteriological evaluations were performed on treatment days 5–7, and within two to ten and 15 to 56 days post-treatment. The post-treatment clinical success and bacteriological cure rates for clarithromycin were 95% (41/43) and 88% (38/43), respectively, with both rates 91% (43/47) for penicillin VK. Three clarithromycin patients withdrew because of adverse events, but only one of these events was possibly drug related. More clarithromycin patients (19/65) reported digestive system related adverse events than did penicillin VK patients (8/63); however, there was no significant difference between treatment groups in the overall number of patients reporting adverse events. Clarithromycin (250 mg, 12-hourly) is as safe and effective as penicillin VK (250 mg, 6-hourly) in the treatment of streptococcal pharyngitis.

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