Treating strep throat the old way isn't working anymore

When it comes to treating strep throat, older types of antibiotics are increasingly less likely to kill the germ that causes millions of sore throats, fevers and missed school days for children each year.

Yet recent studies show that as many as 90 percent of children treated for strep still get amoxicillin or penicillin rather than newer antibiotics known as cephalosporins.

One study presented at a recent scientific meeting on antimicrobials found that taking the newer drugs even for a few days is more effective against strep than the traditional 10-day course of the older antibiotics.

Pediatricians at the University of Rochester Medical Center found that 25 percent of children treated for strep with penicillin ended up back in the doctor's office within three weeks of treatment.

Children treated with amoxicillin returned 18 percent of the time. But repeat visits fell to 14 percent for youngsters who got older-generation cephalosporins, and to just 7 percent for newer types of the drugs, such as cefpodoxme and cefdinir, which can typically be given for just four or five days.

The study reviewed treatment of 11,426 children. The research was an expanded version of another study that looked at the experience of about 7,000 children.

"Most doctors are shocked to learn of the high failure rates of the older medications," said Dr. Michael Pichichero, a professor of microbiology and immunology at Rochester and co-author of the study.

"The paradigm for treating strep sore throats has been changing slowly, and endorsing the use of cephalosporins as a first-time treatment is something that needs to be seriously considered," Pichichero said.

Treatment guidelines for strep issued by the American Academy of Pediatrics, the American Heart Association and the World Health Organization all call for penicillin or amoxicillin as first drugs of choice, despite evidence that resistance to those drugs may be on the rise.

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