meta-analysis compared 6 studies that looked at the dosing interval
of penicillin for streptococcal pharyngitis, specifically QD/BID vs
study was assigned a quality score based on 3 categories: 1) diagnostic
accuracy (if the study was done Dec-May, excluded anyone less than 3
years, and if diagnosis was made by symptoms of streptococcal pharyngitis,
not viral pharyngitis); 2) distinguish re-infection after cure from
persistent infection (follow-up cultures within 14 days of completing
treatment; comparing pre-treatment and post-treatment GABHS serotypes);
3) general elements of study design (investigators blind to treatment,
compliance of treatment assessed, subject withdrawals and reasons for
withdrawal discussed, assessed adequacy of randomization by demographic
meta-analysis measured the difference in the proportion of each treament
group cured, with a 95% confidence interval.
was no difference in the cure rate between BID and TID/QID dosing of
dosing of penicillin had a decreased efficacy in treating streptococcal
study also analyzed a few subgroups: no difference in cure rate was
found within the pediatric population; no difference was found based
on the total daily dose of penicillin.
the 6 studies analyzed, only one study had a treatment arm for amoxicillin.