Clinical Comparison of Once-Daily Cefadroxil and Thrice-Daily Cefaclor in the Treatment of Streptococcal Pharyngitis

Abstract

The efficacy of cefadroxil once daily and cefaclor given 3 times daily was compared in 250 pediatric patients with group A β-hemolytic streptococcal pharyngitis. The duration of the therapy was 10 days. Therapeutic response was based on clinical responses at 24 h and 10 days and throat cultures on days 14, and 21 or 28. Five (5%) cefa-droxil-treated patients and 12 (12%) cefaclor-treated patients were still culture-positive on day 14. When the patients were stratified according to major differences between treatment groups observed at baseline, a significant difference between the treatment groups in favor of cefadroxil was found on day 14 (p = 0.020) and days 21–28 (p = 0.043). These data were confirmed by the clinical findings; failure or clinical recurrence occurred in 4.6% of cefadroxil-treated patients versus 22.1 % of cefaclor-treated patients. The patients complied with the recommended drug regimen, and none experienced any significant drug-related adverse reactions. The results of this study indicate that cefadroxil given once daily for streptococcal pharyngitis is an effective and well-tolerated antimicrobial agent, and suggest that the desirable pharmacokinetic properties of cefadroxil contribute to this efficacy.

Species differences in the pharmacokinetics of cefadroxil as determined in wildtype and humanized PepT1 mice

“…It is used to treat urinary tract infections [16], skin and soft tissue infections [17, 18], pharyngitis [19, 20] and tonsillitis [21]. Cefadroxil has low plasma protein binding (~20%) and good oral bioavailability of at least 90% [22, 23].…”