A multicenter, randomized, single-blind evaluation of cefuroxime axetil and phenoxymethyl penicillin in the treatment of streptococcal pharyngitis.

Ninety-three children from four pediatric practices, with clinical and bacteriologic evidence of acute Group A beta-hemolytic streptococcal pharyngitis (GABHS) randomly received cefuroxime axetil (60 cases) or phenoxymethyl penicillin (33 cases). Cefuroxime axetil was given twice daily (125 mg). Phenoxymethyl penicillin was given three times daily (250 mg). The treatment groups were similar. Throat cultures were routine 2 to 7 days after the start of therapy and 2 days and 14 days after the end of therapy. The bacterial cure rates were 85 percent (51/60) for cefuroxime axetil, and 88 percent (29/33) for phenoxymethyl penicillin treated patients. Clinical results were comparable in both treatment groups. It was concluded that cefuroxime axetil given twice daily is as effective as phenoxymethyl penicillin given three times daily in producing bacteriologic eradication and clinical symptomatic improvement in children with GABHS.

Comparison of oral cephalosporins with penicillin therapy for group A streptococcal pharyngitis.

The purpose of the study was to compare the efficacy of cefaclor with that of penicillin V potassium (penicillin) in patients with Group A streptococcal pharyngitis. One hundred four children with pharyngitis and serologically confirmed Group A streptococci were randomly treated with cefaclor or penicillin using a mean dosage of 20 mg/kg/day for 10 days. The difference in failure rates (14% for 51 cefaclor- and 30% for 53 penicillin V-treated patients) was statistically significant (P = 0.04). In four earlier similar studies I found that cephaloglycin, cephalexin (two studies) and cefatrizine were consistently but not significantly more effective than penicillin therapy. When the data from the five studies are combined the difference between the failure rates (11% for 263 oral cephalosporin- and 23% for 230 penicillin-treated patients) becomes highly significant (P less than 0.001). The 95% confidence interval for the odds for treatment failure are 2.4 times greater for patients receiving penicillin than for those receiving one of the oral cephalosporins. On the basis of these data I conclude that the oral cephalosporins appear to be more effective than penicillin for therapy of Group A streptococcal pharyngitis.

Comparison between cephalexin two- and four-time per day regimens in group A streptococcal pharyngitis.

In previous studies, twice daily (bid) and four times daily (qid) administration of most antibiotics approved for group A streptococcus (GAS) pharyngitis therapy have been demonstrated to be equally effective. In this study, four investigators collaborated in a double-blind, randomized multicenter study assessing the efficacy of cephalexin given in doses of 1.0 g or 0.5 g daily on a bid or qid regimen for 10 to 14 days to 157 patients with GAS pharyngitis. The mean daily doses for patients on the bid and qid regimens were 30 mg/kg and 29 mg/kg, respectively. Pretreatment and two follow-up cultures, usually 2 to 6 and 12 to 16 days after the end of treatment, were taken on all patients. Failure, defined as recurrence of the original GAS M-precipitin and T-agglutination types on follow-up culture, occurred in 7.3 percent of 82 patients on the bid and 5.3 percent of 75 patients on the qid regimen. We conclude that cephalexin bid and qid regimens are equally effective, and that the bid regimen can be recommended for all antibiotics approved for GAS pharyngitis therapy.

An insertion technique for the double-closed-loop posterior chamber lens.

We have developed a technique for inserting double-closed-loop posterior chamber implants that minimizes zonular stress with both ciliary sulcus and capsular bag insertion and facilitates in-the-bag placement if desired.

Warburg syndrome.

Warburg syndrome is a congenital oculocerebral disorder. It is caused by a genetic defect that simultaneously affects ocular and cerebral embryogenesis. The characteristic ophthalmic findings reflect the cerebral malformation (agyria or lissencephaly). Two cases, siblings, have been described. The characteristic bilateral ocular findings (leukocoria with microphthalmia) have been discussed and contrasted with simulating entities. Since Warburg syndrome is a lethal disorder, it is important to distinguish these affected infants from those with hydrocephalus with a known better prognosis. Lastly, the early recognition of this autosomal recessive disorder should prompt genetic parental counseling.

An intraocular lens carrier.

An intraocular lens carrier for anterior and posterior chamber lenses has been developed. The device consists of a protective polypropylene envelope with an insertion leaf, which allows anterior chamber lenses to be inserted without iris or corneal touch and posterior chamber lenses to be guided into the ciliary sulcus or capsular bag with minimal or no haptic manipulation. +