Treatment of streptococcal tonsillitis with amoxicillin, prescribed once a day: results of a meta-analysis

The aim of the systematic review by Spanish scientists was to determine whether the once-daily treatment with amoxicillin streptococcal pharyngitis / tonsillitis is comparable in clinical and microbiological efficacy with other regimens. '' amoxicillin (every 8 or 12 hours) or with phenoxymethylpenicillin.

One meta-analysis included randomized controlled clinical trials comparing once daily amoxicillin to other dosing regimens (every 8 or 12 hours) or to phenoxymethylpenicillin (every 6, 8 or 12 hours).

Searches were performed in the Medline, Central, EMBASE and Google Scholar databases. The research results were combined using a difference in risk indicator (or reduction in absolute risk - difference in risk).

The efficacy of each treatment regimen was evaluated on the basis of a negative bacteriological examination of the smear from the posterior pharyngeal wall on days 14-21 in the case of a culture study initially positive for the presence of beta-hemolytic streptococci. of group A and clinical ineffectiveness on days 10-21 from the start of treatment.

It was found that 4 randomized controlled trials met the criteria for inclusion in a meta-analysis with a total number of participants 1314 (657 patients received amoxicillin 1 time per day and 657 received a different antibiotic or a different dosing regimen of amoxicillin).

The main results of this meta-analysis are as follows:

That is, according to the results of a meta-analysis, no statistically significant difference was found for all of the parameters compared.

Thus, amoxicillin, prescribed once a day, is no worse than using amoxicillin with a higher dosage rate or administering phenoxymethylpenicillin 2-3-4 times a day. The results of this meta-analysis are very important in terms of increased adherence to treatment.