Cefetamet pivoxil in pharyngotonsillitis due to group A beta-hemolytic streptococci

Pharyngotonsillitis due to group A beta-hemolytic streptococci was treated in 524 adults and children in an open, randomized comparative multicenter study. Cefetamet pivoxil (CAT), an oral cephalosporin of the third generation, was given for 7 or 10 days mainly in the standard dose of 500 mg BID to 175 adults and 10 mg/kg BID to 186 children. CAT was compared with the drug of choice phenoxymethylpenicillin (PEN) given for 10 days to 107 adults and 56 children in treatment doses recommended by the manufacturers. The eradication rate of group A beta-hemolytic streptococci was 99% in the CAT groups, and 93% in the PEN groups; the clinical outcome was rated successful in 96% and 90%, respectively. The incidence rate of adverse events, which were all of mild to moderate severity, was 7.5% (27/361) with CAT and 12.9% (21/163) with PEN. Proteinuria (>30 mg/100 ml) occurred in 12.5% (29/231) before start of treatment with trial drugs. At follow-up proteinuria was reported in none of the patients treated with CAT and in 7% (4/59) of those treated with PEN. We conclude that CAT, given in the standard doses twice daily, can reduce treatment duration to 7 days, which may improve compliance compared with the 10-day course of PEN given three times daily.