Comparison of clarithromycin suspension and amoxycillin syrup for the treatment of children with pharyngitis and/or tonsillitis.

Twenty-three general practices in the UK randomised 229 paediatric patients (aged 1-12 years, body weight > 8 kg) with clinical evidence suggestive of streptococcal tonsillitis and/or pharyngitis in this physician-blind study. Patients received either clarithromycin suspension (7.5 mg/kg twice daily) or amoxycillin syrup (125 mg/kg three times daily body weight < 25 kg, or 250 mg/kg three times daily body weight 25 kg) for 7 days and were followed up 3-8 days post treatment and 21-28 days later. Clinical and microbiological assessments were made at each visit. A total of 189 patients (98 on clarithromycin and 91 on amoxycillin) were clinically evaluable. At the post-treatment visit, clinical success rates were high and comparable: 98% on clarithromycin and 97% on amoxycillin. Streptococcus pyogenes was eradicated in 88% of clarithromycin patients and 86% of amoxycillin patients. Both treatments were well tolerated. In conclusion, clarithromycin suspension was as safe and at least as effective as amoxycillin syrup for the treatment of pharyngitis and/or tonsillitis in children, and would be a suitable alternative therapy.