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For many decades, a 10-day course of oral penicillin was recommended for the cure of pharyngitis and pharyngotonsillitis caused by group A streptococcus. Several recent studies suggest that shorter courses can effectively treat these conditions.
In a randomized, open-label, controlled study, investigators compared the European standard regimen of 1000 mg penicillin V three times daily for 10 days with a course of 800 mg four times daily for 5 days. Enrollment required having at least three of four Centor clinical criteria plus a positive rapid streptococcal test. The primary outcome was noninferiority in clearing clinical infection at 5 to 7 days after antibiotic treatment; secondary outcomes were relapse and complications.
In the per-protoco…