• Pediatric Infection and Vaccine
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• v.8 no.1
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• pp.90-93
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• 2001

Purpose : The accurate diagnosis and proper treatment of group A streptococal infection should be emphasized concerning about possible development of late sequelae, such as acute rheumatic fever and acute glomerulonephritis. Inadequate & improperance of antobiotics have resulted in increased number of antibiotic-resistant bacteria. We would like to know the clinical usefulness of rapid strep test compared with conventional throat culture in out-patients with acute pharyngotonsilitis. Methods : From Sep. 2000. to Jan. 2001, rapid strep test(LINK 2 Strep A, USA) & throat culture were taken from 87 patients with clinically suspect pharyngotonsilitis from Masan Fatima hospital & kyunghee university hospital. Results : Of 87 cases with pharyngitis, 39 cases proved to have group A streptococci by throat culture. The positive predictive value of rapid test was 92.3%(36 of 39 cases) and sensitivity test was 81.8%(36 of 44 cases). The specificity of rapid test was 93.0%(40 of 43 cases) and negative predictive value was 83.3%(40 of 48 cases). Conclusion : The positive predictive value & specificity of rapid strep test is high. And so, this test will give the pediatricians practical guidance of antibiotic use in patients with pharyngitis. But more efforts should be made to prevent antibiotics abuse and correct diagnosis of pharyngitis.

• Pediatric Infection and Vaccine
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• v.8 no.2
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• pp.206-212
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• 2001

Objective : To determine the clinical and bacteriologic efficacy and safety of Cefprozil in acute pharyngitis and pharyngotonsilitis caused by Group A beta hemolytic streptococci in pediatric patients. Methods : Any patient of 3 to 14 age who visited the hospitals enrolled in this study with the signs and symptoms of pharyngitis or pharyngotonsilitis since July, 2000 to March, 2001, was taken throat culture and given Cefprozil(15 mg/kg/day, in two divided doses) for 10 days. 138 patients of whom showed positive culture results were followed up for the signs and symptoms during the treatment to determine clinical efficacy. Any undesirable effect was reported to determine the safety of the drug. Follow up cultures were done at the end of the study and bacteriologic efficacy was determined. Results : 138 of 256 patients who visited the hospitals with the signs and symptoms of pharyngitis or pharyngotonsilitis showed positive growth on throat culture. Mean age of the patients was $6.1{\pm}2.5$ and males and females were equally numbered. 129 of them complained fever on the first visit and 112(86.6%) of them were improved at the end of the study. Cervical lymphadenitis was seen in 58 patients and 44(75.9%) of them improved at the end of the study. Exudative pharyngitis was seen in 96 patients and 81(84.3%) of them improved. The overall clinical effcacy based on this results showed that 110(79.7%) of the patients were cured and 17(12.3%) of them improved. On the cultures and bacteriologic efficacy, 24.6% of them showed documented eradication after treatment and 62.3% of them showed presumptive eradication. Sensitivity test was done by agar dilution method and Cefprozil showed 100% sensitivity. Erythromycin, Clarithromycin and azithromycin showed 87%, 85.6 %, 90.6% sensitivity, respectively. Conclusion : Cefprozil is proved to be effective in controlling group A streptococcal pharyngitis and pharyngotonsilitis in children and showed good sensitivity. Cefprozil can be used as an effective oral cephalosporin in the patients showing penicillin hypersensitivity or patients who other drugs have failed.