Penicillin vs. erythromycin in the treatment of diphtheria.
In an open-label, randomized trial, 44 Vietnamese children with diphtheria were given penicillin therapy (intramuscular benzylpenicillin, 50,000 U/[kg.d] for 5 days and then oral penicillin, 50 mg/[kg.d] for 5 days), and 42 were given erythromycin therapy (50 mg/[kg.d] orally for 10 days). There wer...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Journal article |
| Language: | English |
| Published: |
1998
|
| _version_ | 1797071167648956416 |
|---|---|
| author | Kneen, R Pham, N Solomon, T Tran, T Nguyen, T Tran, B Wain, J Day, N Tran, T Parry, C White, N |
| author_facet | Kneen, R Pham, N Solomon, T Tran, T Nguyen, T Tran, B Wain, J Day, N Tran, T Parry, C White, N |
| author_sort | Kneen, R |
| collection | OXFORD |
| description | In an open-label, randomized trial, 44 Vietnamese children with diphtheria were given penicillin therapy (intramuscular benzylpenicillin, 50,000 U/[kg.d] for 5 days and then oral penicillin, 50 mg/[kg.d] for 5 days), and 42 were given erythromycin therapy (50 mg/[kg.d] orally for 10 days). There were no differences in times to membrane clearance or bacteriologic clearance, but median times to fever clearance were 27 hours (95% confidence interval [CI], 19-30; range, 0-124 hours) for penicillin recipients and 46 hours (95% CI, 34-54; range, 0-148 hours) for erythromycin recipients (P = .0004). In the penicillin group, acute treatment failed for one patient, and one patient relapsed. Three patients in the penicillin group developed diphtheritic myocarditis as evidenced by abnormal electrocardiograms. Erythromycin did not cause prolongation of the QT interval corrected for heart rate. Cultures of specimens from 15 patients (17.4%) were positive for toxigenic Corynebacterium diphtheriae. All isolates were susceptible to penicillin, but for isolates (27%), all of which were from patients who received penicillin treatment, were resistant to erythromycin (minimum inhibitory concentrations, > 64 mg/L). Penicillin is recommended as first-line treatment for diphtheria in Vietnam. |
| first_indexed | 2024-03-06T22:49:23Z |
| format | Journal article |
| id | oxford-uuid:5e4a39d3-bc31-4e5f-ac50-8da6a9172e3f |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T22:49:23Z |
| publishDate | 1998 |
| record_format | dspace |
| spelling | oxford-uuid:5e4a39d3-bc31-4e5f-ac50-8da6a9172e3f2022-03-26T17:39:48ZPenicillin vs. erythromycin in the treatment of diphtheria.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:5e4a39d3-bc31-4e5f-ac50-8da6a9172e3fEnglishSymplectic Elements at Oxford1998Kneen, RPham, NSolomon, TTran, TNguyen, TTran, BWain, JDay, NTran, TParry, CWhite, NIn an open-label, randomized trial, 44 Vietnamese children with diphtheria were given penicillin therapy (intramuscular benzylpenicillin, 50,000 U/[kg.d] for 5 days and then oral penicillin, 50 mg/[kg.d] for 5 days), and 42 were given erythromycin therapy (50 mg/[kg.d] orally for 10 days). There were no differences in times to membrane clearance or bacteriologic clearance, but median times to fever clearance were 27 hours (95% confidence interval [CI], 19-30; range, 0-124 hours) for penicillin recipients and 46 hours (95% CI, 34-54; range, 0-148 hours) for erythromycin recipients (P = .0004). In the penicillin group, acute treatment failed for one patient, and one patient relapsed. Three patients in the penicillin group developed diphtheritic myocarditis as evidenced by abnormal electrocardiograms. Erythromycin did not cause prolongation of the QT interval corrected for heart rate. Cultures of specimens from 15 patients (17.4%) were positive for toxigenic Corynebacterium diphtheriae. All isolates were susceptible to penicillin, but for isolates (27%), all of which were from patients who received penicillin treatment, were resistant to erythromycin (minimum inhibitory concentrations, > 64 mg/L). Penicillin is recommended as first-line treatment for diphtheria in Vietnam. |
| spellingShingle | Kneen, R Pham, N Solomon, T Tran, T Nguyen, T Tran, B Wain, J Day, N Tran, T Parry, C White, N Penicillin vs. erythromycin in the treatment of diphtheria. |
| title | Penicillin vs. erythromycin in the treatment of diphtheria. |
| title_full | Penicillin vs. erythromycin in the treatment of diphtheria. |
| title_fullStr | Penicillin vs. erythromycin in the treatment of diphtheria. |
| title_full_unstemmed | Penicillin vs. erythromycin in the treatment of diphtheria. |
| title_short | Penicillin vs. erythromycin in the treatment of diphtheria. |
| title_sort | penicillin vs erythromycin in the treatment of diphtheria |
| work_keys_str_mv | AT kneenr penicillinvserythromycininthetreatmentofdiphtheria AT phamn penicillinvserythromycininthetreatmentofdiphtheria AT solomont penicillinvserythromycininthetreatmentofdiphtheria AT trant penicillinvserythromycininthetreatmentofdiphtheria AT nguyent penicillinvserythromycininthetreatmentofdiphtheria AT tranb penicillinvserythromycininthetreatmentofdiphtheria AT wainj penicillinvserythromycininthetreatmentofdiphtheria AT dayn penicillinvserythromycininthetreatmentofdiphtheria AT trant penicillinvserythromycininthetreatmentofdiphtheria AT parryc penicillinvserythromycininthetreatmentofdiphtheria AT whiten penicillinvserythromycininthetreatmentofdiphtheria |