Pediatric Infection and Vaccine

The Korean Society of Pediatric Infectious Diseases (대한소아감염학회)
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Clinical and Bacteriologic Efficacy of Cefdinir on Pharyngitis and Pharyngotonsillitis Caused by Group A Beta Hemolytic Streptococci in Children

Group A-beta Hemolytic Streptococci에 의한 소아 인두편도염에 있어서 Cefdinir의 항균력과 임상적 및 세균학적 효과에 관한 연구

  • Chung, Ji-Young (Department of Pediatrics, College of Medicine, Kyung-Hee University) ;
  • Sin, Seon-Hee (Department of Pediatrics, College of Medicine, Hallym University) ;
  • Ahn, Young-Min (Department of Pediatrics, Kang-Nam Municipal Hospital) ;
  • Ahn, Byung-Moon (Department of Pediatrics, Kwangmyung Sung-Ae Hospital) ;
  • Sin, Young-Gyu (Department of Pediatrics, College of Medicine, Korea University, Ahnsan Hospital) ;
  • Bae, Young-Min (Department of Pediatrics, Dong Su Won Hospital) ;
  • Park, Soo-Eun (Department of Pediatrics, College of Medicine, Busan University) ;
  • Kim, Jong-Guk (Department of Pediatrics, College of Medicine, Won-Kwang University) ;
  • Lee, Jong-Guk (Department of Pediatrics, CoIlege of Medicine, Inje University, Ilsan Paik Hospital) ;
  • Ma, Saung-Hyuk (Department of Pediatrics, Changwon Fatima Hospital) ;
  • Chang, Jin-Kun (Department of Pediatrics, Han-Il General Hospital) ;
  • Cha, Sung-Ho (Department of Pediatrics, College of Medicine, Kyung-Hee University)
  • 정지영 (경희대학교병원 소아과) ;
  • 신선희 (한림대학교 의과대학 강남성심병원) ;
  • 안영민 (강남시립병원 소아과) ;
  • 안병문 (광명성애병원 소아과) ;
  • 신영규 (고려대학교 의과대학 안산병원 소아과) ;
  • 배영민 (동수원병원 소아과) ;
  • 박수은 (부산대학교병원 소아과) ;
  • 김종국 (원광대학교병원 소아과) ;
  • 이종국 (인제대학교 의과대학 일산백병원 소아과) ;
  • 마상혁 (창원파티마병원 소아과) ;
  • 장진근 (한일병원 소아과) ;
  • 차성호 (경희대학교병원 소아과)
  • Published : 2003.05.31
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Abstract

Objective : To determine the clinical and bacteriologic efficacy and safety of Cefdinir in acute pharyngitis and pharyngotonsillitis caused by group A beta hemolytic streptococci in pediatric patients. Methods : Children aged 3 through 12 years who visited the hospitals enrolled in this study with signs and symptoms of pharyngitis or pharyngotonsillitis since May to December 2002, were taken throat culture and given Cefdinir(12 mg/kg/day, in three divided doses) for 7 days. Two hundred thirty five patients were enrolled and 90 patients who showed positive culture results were followed up for the signs and symptoms during the treatment to determine clinical efficacy. Follow-up culture were done at the end of the study and bacteriologic efficacy was determined Results : Ninety out of 235 patients who visited the hospitals with the signs and symptoms of pharyngitis showed positive growth on throat culture. Seventy nine patients were clinically and microbiologically assessable. The bacteriologic eradication rates of S. pyogenes were 100% in all the children treated with Cefdinir. Clinical cure rates were not different between less than 7 days-treated group(75%) and just 7 days-treated group(98.6%)(P=0.077). Two patients reported adverse reaction during Cefdinir treatment. Antimicrobial sensitivity of Cefdinir against S. pyogenes was 100% with range of MIC being less than 0.5 ${\mu}g/mL$. Conclusion : It seems that Cefdinir is one of reliable and well-tolerated drugs for the treatment of group A beta hemolytic streptococcal pharyngotonsillitis in children. It needs to be investigated short term efficacy in terms of improving drug compliance and impact of economic point of view. We can recognized that still high rate of the erythromycin resistant group A streptococci in our community should be monitored every year.

최근 국내 erythromycin 내성률이 증가하는 추세임을 보고하였고 erythromycin의 경우 내성의 증가는 항생제 사용량의 증가와 일치하고 있음을 보고하였다. 그래서 macrolide에 의한 내성균주의 확산을 막고 임상에서 보고되는 penicillin에 의한 치료 실패를 줄이기 위해 A군 연쇄구균 치료에 제일차 약물로 cephalosporin을 고려할 수 있다. Cefdinir의 A군 연쇄구균에 대한 항균력과 인두 편도염에 대한 우수한 임상효과 및 높은 안전성을 미루어 볼 때, Cefdinir는 A군 연쇄구균에 의한 소아 인두 편도염에 유효한 항생제로 사용될 수 있다.

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