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Penicillin, the old standard antibiotic for treating group A streptococcal infections, has become less effective because of higher failure and recurrence rates. This study compared cephalexin with penicillin in children with group A beta-hemolytic streptococcal tonsillopharyngitis.
Researchers randomized 525 children from seven pediatric practices in the U.S. to receive either penicillin or cephalexin (27 mg/kg/day) in 4 doses for 10 days. All patients had symptoms of strep throat and positive cultures for group A beta-hemolytic streptococcal infection. More penicillin-treated patients than cephalexin-treated patients had symptomatic relapse with the original infecting serotype (8 percent vs. 3 percent) and bacteriologic failure (11 percent …