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Penicillin has been used to treat group A β-hemolytic streptococcal (GABHS) tonsillopharyngitis for longer than 5 decades. However, treatment with cephalosporins has become more common during the past 20 years. Investigators in New York conducted an updated meta-analysis of data from 35 randomized trials, published since 1970, that compared 10-day treatment with cephalosporins or with penicillin in 7125 patients (age, younger than 18) who had bacteriologically confirmed GABHS tonsillopharyngitis.
Summary odds ratios significantly favored cephalosporins for both bacteriologic cure rate (93% vs. 81%; OR, 3.02) and clinical cure rate (94% vs. 86%; OR, 2.34). Cephalosporins that were superior to penicillin included cephalexin, cefadroxil, cefuro…