Erythromycin therapy for group A streptococcal pharyngitis. Results of a comparative study of the estolate and ethylsuccinate formulations
C. M. Ginsburg, G. H. McCracken Jr, S. D. Crow, B. R. Dildy, G. Morchower, J. B. Steinberg and K. Lancaster
One hundred two children with group A streptococcal pharyngitis were
treated on a randomized basis with either 15 mg/kg of erythromycin estolate
or 25 mg/kg of erythromycin ethylsuccinate given twice daily for ten days.
Twelve patients, including 11 erythromycin ethylsuccinate-treated patients
and one erythromycin estolate-treated patient, were dropped from the study
at the request of their parents because of abdominal cramping and/or nausea
and vomiting that occurred 15 to 45 minutes after ingestion of drug.
Eighteen other patients (12 treated with erythromycin ethylsuccinate and
six treated with erythromycin estolate) had similar gastrointestinal (GI)
tract symptoms that resolved or abated. Excluding patients with
reinfections with new streptococcal serotypes and those with resistant
strains, the bacteriologic failure rates were 4.3% and 17.5%, and the total
failure rates were 6.4% and 35.3% with erythromycin estolate therapy and
with erythromycin ethylsuccinate therapy, respectively. The high rate of GI
tract intolerance associated with the erythromycin ethylsuccinate appears
to be dose related.
