Comparison of cephaloglycin and penicillin in streptococcal pharyngitis

Cephaloglycin, 0.5 Gm. orally daily for 10 days (Regimen 1); K phenoxymethyl penicillin, 0.5 Gm. orally daily for 10 days (Regimen 2); K phenoxymethyl penicillin, 1.0 Gm. orally daily for 7 days (Regimen 3); and benzathine penicillin G, 0.5 Gm. once intramuscularly (Regimen 4) were compared in 180 patients with group A streptococcal pharyngitis. The regimens were assigned randomly. Bacterial failure rates for primary treatments were: Regimen 1, 10 per cent; 2, 17 per cent; 3, 28 per cent; and 4, 9 per cent. Bacterial failure rates for retreatments were: Regimen 1, 29 per cent; 2, 67 per cent; and 4, 75 per cent. Possible side efJects of Regimen 1 were generalized maculopapular rashes in 11, other rashes in 2, and mild diarrheas in one third. The minimal inhibitory concentrations of cephaloglycin and penicillin G for 98 group A streptococci averaged 0.2 P,g per milliliter and 0.01 P,g per milliliter, respectively. Cephaloglycin concentrations showed a mean average of 0.8 P,g per milliliter in 30 sera obtained 1 to 2 hours after ingestion of 125 mg. doses during therapy.