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Perianal dermatitis caused by group A β-hemolytic streptococci (GABHS) is characterized by perianal rash with itching, blood-streaked stools, and constipation. GABHS is often misdiagnosed, and reported recurrence rates after penicillin treatment are high (up to 39%). In a randomized clinical trial, Swiss investigators compared a 7-day course of oral cefuroxime and a 10-day course of oral penicillin in 35 children (age range, 1–16 years) with perianal dermatitis and positive anal swab cultures for GABHS.
The study was terminated early because clinical improvement and bacteriologic cure were superior with cefuroxime than with penicillin. At the end of therapy, children who received cefuroxime were significantly less likely to have positive cul…