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Long-Course Antibiotics Work Better Than Short-Course for Strep Throat

 


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This is the Medscape Medical Minute. I'm Dr. George Lundberg.

How long should one treat culture-proven group A beta-hemolytic streptococcal tonsillopharyngitis? Publishing in the Proceedings of the Mayo Clinic in 2008, 5 authors from Greece performed a meta-analysis of 11 randomized controlled trials including 1607 patients with the endpoint of bacterial eradication.[1] Short-course antibiotics (5-7 days) was inferior to long-course (10 days) with an odds ratio of 0.49. The odds ratio for penicillin V short-course was only 0.36, while oral cephalosporin was better, but not good, at 0.62. Microbiologic eradication by short- vs long-course treatment in children and adolescents was only 0.63. Clinical success was also inferior, with short-course at a 0.49 odds ratio. Adverse events did not differ. Clearly, a 10-day course of antibiotics is the correct treatment for culture-proven strep throat.

This article is selected from Medscape Best Evidence.[2] I'm Dr. George Lundberg.

 


 

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