Treatment of patients with acute recurrent tonsillitis due to group A beta-haemolytic streptococci: a prospective randomized study comparing penicillin and amoxycillin/clavulanate potassium.

The failure of penicillin to eradicate Group A beta-haemolytic streptococcal tonsillitis may be caused by beta-lactamase producing bacteria in the tonsillar tissue. A prospective randomized clinical study comparing the efficacy of penicillin-V potassium with amoxycillin plus clavulanate potassium (Augmentin) in the treatment of acute episodes of recurrent streptococcal tonsillitis was conducted. Twenty children were included in each group. Surface tonsillar cultures were obtained before therapy, ten days after termination of therapy, and then once every two months for up to one year. beta-Lactamase producing aerobic and anaerobic bacteria were present in 34 of the 40 (85%) tonsillar cultures prior to treatment. Group A beta-haemolytic streptococci were eradicated in 14 of 20 (70%) patients treated with penicillin and in all those treated with amoxycillin/clavulanate potassium (P less than 0.001). In a one-year follow-up, 11 of the 19 patients treated with penicillin and two of the 18 treated with amoxycillin/clavulanate potassium had recurrent streptococcal tonsillitis (P less than 0.005). This study demonstrates the efficacy of amoxycillin/clavulanate potassium in the therapy of acute episodes of recurrent tonsillitis and prevention of recurrent infection.