A noncomparative trial of cefixime therapy for pharyngitis and cystitis

Cefixime, a new third-generation oral cephalosporin antibiotic, was evaluated for safety and efficacy in children with acute bacterial pharyngitis or cystitis. Patients were treated for ten days with cefixime, either 8 mg/kg once daily (186 patients) or 5 mg/kg BID (189 patients). Of 375 children enrolled, 212 met all criteria for the efficacy analysis. Streptococcus pyogenes was isolated in 79% of the pharyngitis cases and Escherichia coli was the most frequently isolated organism in those patients with cystitis. Favorable clinical responses (cure/improvement) were obtained in 99% of the evaluable patients (209/212), and the overall bacteriological eradication rate was 98% (208/212). An additional 43 patients with pneumonia were treated and were included in the safety assessments only. Drug-related adverse effects occurred in 22.2% of all patients. These reactions were generally mild, and only seven patients (1.7%) were withdrawn from the study as a result of adverse effects, the most common of which were diarrhea and loose stools (67/418, or 16%). We conclude that cefixime is safe and effective in the treatment of streptococcal pharyngitis and bacterial cystitis in children.