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Comparative Study of Oral Daily Amoxicillin, Long Acting Intramuscular Penicillin, and Tonsillectomy in Prevention of Recurrent Pharyngitis

Amira S Ahmed, Engy A Wahsh, Essam Eldin G. Ahmed.




Abstract

Pediatric recurrent pharyngitis represents a huge global health burden causing much morbidity and mortality in children. The aim of the study was to compare the efficacy of oral daily amoxicillin, intramuscular penicillin, and tonsillectomy in reducing the incidence of recurrent pharyngitis Between July 2012 and June 2013, a total of 100 paediatric patients (56 males and 44 females) diagnosed with recurrent pharyngitis were enrolled in the study. The clinical criterion for study entry was three or more episodes of pharyngitis in six months. The selected patients’ clinical data were recorded and a throat swab was obtained. Patients were divided randomly into three groups A, B, and C. Group A received a monthly ten days course of oral amoxicillin suspension (25mg/kg/day) for six months, group B received a single dose of intramuscular benzathine penicillin G every 3 weeks for 6 months and group C included patients who undergo tonsillectomy. All patients were scheduled for a monthly follow-up visit, during which they the number of recurrent pharyngitis episodes, compliance, adverse events and drug tolerability were assessed. All treatment regimens significantly decreased recurrences. While oral amoxicillin and IM penicillin efficacy were comparable, tonsillectomy was similarly effective to IM penicillin treatment and more effective than oral amoxicillin therapy. The once daily oral amoxicillin is a safe, effective and convenient alternative to IM penicillin in reducing the incidence of recurrent pharyngitis. Tonsillectomy is also a suitable alternative, however its possible related morbidity and mortality should be considered.

Key words: Recurrent pharyngitis, prevention, amoxicillin, intramuscular benzathine penicillin G






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