Penicillin V twice daily vs. Four times daily in the treatment of streptococcal pharyngitis

Treatment failure of streptococcal pharyngitis with oral penicillin might be due to patient noncompliance. We performed a randomized controlled study of 104 patients with group A ß-hemolytic streptococcal pharyngitis; 51 patients received penicillin V 1 g twice daily and 53 patients, 500 mg four times a day for 10 days. At day 9-10 of treatment, the number of patients free of symptoms was significantly greater in the twice-daily than in the four-times-daily group (92% vs. 77%); similarly, the number of patients with sterile throat cultures was significantly greater in the twice-daily group (90% vs. 73%). Differences in clinical and bactériologie responses were still significant 28 days posttherapy. Compliance was 90% in the twice-daily group vs. 58%. Penicillin V given twice daily is more effective than a four-times-daily regimen in the treatment of streptococcal pharyngitis, probably because patient compliance is improved.