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Ten days of oral penicillin has long been the standard treatment for group A β-hemolytic streptococcus (GABHS) pharyngitis. Investigators in France compared this standard regimen to shorter courses of azithromycin in a prospective, randomized trial of 501 children, aged 2 to 12 years, with symptoms of acute pharyngitis that were confirmed by throat culture. The trial was supported by the manufacturer of azithromycin.
Patients received azithromycin suspension at 10 mg/kg or 20 mg/kg once daily for 3 days or penicillin suspension at 45 mg/kg/day in 3 divided daily doses for 10 days. The primary endpoint was microbiologic response (success or failure to eradicate GABHS on day 14). Of the 420 assessable patients, those who received 10-mg/kg azit…