BOTTOM LINE
Treating streptococcal tonsillopharyngitis in children with a cephalosporin instead of penicillin produces significantly more bacteriologic and clinical cures. One additional child will benefit for every 13 children treated with a cephalosporin rather than penicillin. Only the cephalosporins cefaclor (Ceclor) and loracarbef (Lorabid) did not show an advantage over penicillin. The effect of cephalosporin treatment on prevention of rheumatic heart disease is not known. (LOE=1a)