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Review: twice daily dosing of penicillin V is as effective as more frequent dosing for streptococcal tonsillopharyngitis

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 QUESTION: In patients with acute group A β-haemolytic streptococcal (GABHS) tonsillopharyngitis, is once or twice daily dosing of penicillin or amoxicillin less effective than dosing 3 (TID) or 4 (QID) times daily?

Data sources

Studies were identified by searching Medline and Dissertation Abstracts (to August 1998), abstracts of the annual Interscience Conference on Antimicrobial Agents and Chemotherapy (1983 to 1997), and bibliographies of relevant articles.

Study selection

Studies were selected if they were randomised controlled trials (RCTs) that compared different dosing frequencies of 10 day oral penicillin or amoxicillin while keeping the same total daily dose, based the diagnosis of acute GABHS tonsillopharyngitis on symptoms and positive throat culture results or positive antigen detection test results, and began antibiotic treatment at the time of …

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  • * p Value calculated from data in article.

  • Source of funding: no external funding.

  • For correspondence: Dr J M Colford, Jr, University of California, Berkeley, Department of Public Health Biology and Epidemiology, 113 Haviland Hall 7360, Berkeley, CA 94720–7360, USA. Fax +1 510 643 5163.