Cefetamet pivoxil in the treatment of pharyngitis/tonsillitis in children and adults.

Between 15 and 35% of pharyngeal infections are attributable to Group A beta-haemolytic streptococci. Streptococcal pharyngitis is one of the most common infections in adolescents and children. A specific diagnosis of pharyngitis can be obtained only by isolating organisms in culture. The current treatment of choice for streptococcal pharyngitis/tonsillitis is a 10-day course of phenoxymethylpenicillin (penicillin V); however, unresolved problems concerning the use of penicillin include the timing of therapy, appropriate therapy for treatment failures, chronic carriers and those with frequent recurrences. In addition, failure rates of 10 to 35% have been reported with oral phenoxymethylpenicillin. Effective treatment alternatives in this indication include oral cephalosporin agents or penicillin/beta-lactamase inhibitor combinations. The oral cephalosporins offer the advantage of an improved pharmacokinetic profile, once- or twice-daily administration, a shorter (7-day) regimen, and a low incidence of adverse effects, although these advantages must be balanced against the broad spectrum of these agents (broader than is necessary) and their cost. Clinical trials conducted with cefetamet pivoxil, a new oral third generation cephalosporin, in both adults and children with pharyngitis/tonsillitis indicate that this agent offers an effective alternative for phenoxymethylpenicillin in this indication.