COMPARATIVE STUDY BETWEEN ORAL PENICILLIN AND LONG ACTING PENICILLIN IN TREATMENT OF RECURRENT STREPTOCOCCAL TONSILLOPHARYNGITIS.

Background and objectives:- Antimicrobial treatment of GABHS pharyngitis is aimed at reduction of poststreptococcal complications, symptoms, duration, and disease spread. The main goal of our study will be to assess the effect of therapy by long acting penicillin single injection per month versus oral penicillin for 10 days in treatment of children with recurrent streptococcal tonsillopharyngitis by frequent estimation of antistreptolysin o titre (ASOT). Method: Prospective study was done on 50 children suffering from recurrent follicular tonsillitis with high level of anti-streptococcal antibodies (ASOT) (>400 Todd units), age ranges from 3 to 13 years. . The children were classified into 2 groups, group (1) included 25 children had been treated with oral penicillin V (phenoxy methyl penicillin) 10mg/kg/day for 10 days. Group (2) included 25 children had been treated with long acting penicillin single injection of 1.200.000 IU for children >25 KG and 600.000 IU for those <25 KG. Follow up of the children was done by assessment of ASOT at 3months and 6 months in both groups. Results: There was significant reduction in the level of ASOT at 3 and 6 months in both groups in comparison to the level at the time of presentation, however there was no significant difference between the both groups at 3 and 6 months as regards ASOT level. Conclusions: Penicillin remains the treatment of choice for treatment of (GABHS) pharyngitis. There is no difference between oral penicillin and long acting penicillin in treatment of (GABHS) pharyngitis. There was no relationship between the level of ASO titers and the clinical manifestation of (GABHS) pharyngitis.