Original articleRandomized, Comparative Efficacy Trial of Oral Penicillin Versus Cefuroxime for Perianal Streptococcal Dermatitis in Children
Section snippets
Study Design and Sites
This prospective, open, randomized, controlled study was conducted from August 2005 to December 2006 in pediatric practices located in the region of Basel and the outpatient clinic of the University Children's Hospital of Basel.
Inclusion and Exclusion Criteria
Patients 1 to 16 years of age were eligible for enrollment if they presented with either the typical clinical sign of perianal erythema or at least 2 other signs or symptoms such as perianal itching, rectal pain, painful defecation, consequent constipation,
Results
A total of 35 patients (21 boys, 14 girls) were enrolled and randomly assigned to penicillin (n = 18) or cefuroxime (n = 17) treatment. Six of the 35 patients were dropouts (penicillin group, n = 3; cefuroxime group) due to negative initial anal culture (n = 4) or protocol violation (n = 2; refusal of 1 patient to take oral medicine and 1 patient lost to follow-up). No serious adverse event occurred.
Baseline characteristics of patients were similar in both treatment groups (Figure) with the
Discussion
The recommended treatment of choice for perianal dermatitis caused by GABHS has been a 10-day course of penicillin orally. Due to recurrence rates up to 39%,1 alternative antibiotic treatment has been proposed such as with a cephalosporin, macrolide, or a prolonged treatment with penicillin (up to several weeks).5 The current study was a prospective, randomized, controlled comparison assessing the efficacy of a 10-day penicillin treatment with a 7-day cefuroxime treatment.
Our results indicate
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2014, Best Practice and Research: Clinical Obstetrics and GynaecologyCitation Excerpt :Before treatment is commenced for suspected genital streptococcal infection, a swab should always be taken to confirm the diagnosis. A recent randomised controlled trial compared oral penicillin against cefuroxime for Group A beta-haemolytic Streptococcus pyogenes perianal dermatitis in children 1–16 years of age [37]. Clinical improvement was more rapid in the cefuroxime group.
An update on diaper dermatitis
2014, Clinics in DermatologyHurwitz Clinical Pediatric Dermatology, Fouth Edition
2011, Hurwitz Clinical Pediatric Dermatology, Fouth Edition
The authors declare no potential conflicts of interest.
Clinical Trial Register number: NCT00261742.