Comparison of the efficacy of penicillin and cefuroxime in the treatment of perianal streptococcal dermatitis in children

The aim of a randomized study in Switzerland was to compare the efficacy of penicillin for oral administration and cefuroxime in the treatment of perianal dermatitis caused by group A beta-hemolytic streptococcus (BHCA, S. pyogenes).

The study involved children aged 1 to 16 years with signs and symptoms of perianal dermatitis and a positive smear test of the perianal region. Patients were randomized into two groups: 1 group received penicillin (n = 18), the second group received cefuroxime (n = 17). A clinical evaluation of the efficacy of the treatment was carried out on the third day and at the end of the treatment (on day 7 in the group of patients receiving cefuroxime and on day 10 in the group of children receiving penicillin). To confirm the eradication of BHSA, smears from the perianal region were taken at the end of treatment. The severity of the disease has been evaluated on a clinical scale (perianal erythema - 5 points, perianal itching - 3 points, painful stools - 3 points, constipation - 2 points).

During the study, it was found that penicillin was significantly lower than cefuroxime in terms of efficacy, which led to an early termination of the study after consultation with an independent ethics committee. Clinical improvement was faster in the group of patients receiving cefuroxime (p = 0.028). The end of antimicrobial treatment at the end of antimicrobial treatment was reached in 13 patients out of 14 treated with cefuroxime, compared to 7 out of 15 patients treated with penicillin (p less than 0.01).

Thus, cefuroxime was more effective than penicillin in the treatment of perianal dermatitis in children caused by S. pyogenes, and should be considered the drug of choice with this nosological form.