A sore throat that stays

IF it seems that your child’s strep throat is lasting longer than it should, there might be a reason for those extra weeks of painful swallowing and malaise. The commonly prescribed antibiotics penicillin and amoxicillin are becoming less effective against it, according to a study by pediatricians at the University of Rochester Medical Center.

The reason: increased rates of antibiotic resistance among bacteria in the mouth.

The study, conducted by Dr. Michael Pichichero and Dr. Janet Casey, analyzed 47 studies of various drugs used for treating strep in kids. They reported in December that up to 25% of children treated for strep throat with penicillin and 18% treated with amoxicillin end up back in the doctor’s office within three weeks for additional treatment. By contrast, 14% of children receiving older generation cephalosporin antibiotics such as cephalexin, and only 7% of children receiving newer generation cephalosporins, such as cefpodoxime and cefdinir, return to the doctor.

Pichichero and Casey concluded that a four- to five-day regimen of the newest cephalosporins were more effective than other drugs. But they aren’t recommending parents demand these meds. For one thing, they’re more expensive. For another, selecting the strongest drugs could lead to more antibiotic resistance.

“It’s a hard choice,” says Pichichero, “but we wanted to give doctors and parents this information so they can have a dialogue to decide what would be in the best interest of the child.”