Amoxicillin Effect On Bacterial Load In Group A

Streptococcal Pharyngitis: Comparison Of Single And

Multiple Daily Dosage Regimens
Akihiro Nakao* , Ken Hisata, Makoto Fujimori, Nobuaki Matsunaga, Mitsutaka
Komatsu and Toshiaki Shimizu

BMC Pediatrics volume 19, Article number: 205 (2019)

CRITICAL APPRAISAL

General Description
1. Design : A prospective cohort study.
2. Subject : Children (≧3 years of age) diagnosed with GAS pharyngitis in
pediatric department at two medical institutions in Japan
between October 2015 and September 2016.
3. Title : Interesting, concise, explicit, and straight forward
4. Authors : Clearly written institution and there is a correspondence
address.
5. Abstract : Clear and appropriate rules.
6. Introduction : Consist of three paragraphs and contains the background, theory,
and objectives of the study.

Level of Evidence
Level 2 (prospective cohort studies)

Analysis
1. Population :
Children (≧3 years of age) diagnosed with GAS pharyngitis in pediatric
department at two medical institutions in Japan between October 2015 and
September 2016.

1
 2. Intervention :
Single dose amoxicillin at a dose of 40–50 mg/kg/day for 10 days.
3. Comparison :
Two daily dose or three daily dose Amoxicillin at a dose of 40–50 mg/kg/day for
10 days.
4. Outcome :
Single daily dose Amoxicillin regimen was as effective in eradicating group A
streptococcus (GAS) pharyngitis as two daily dose or three daily dose regimens

V-I-A Analysis
1. Validity :
This study used a molecular approach to analyze the efficacy of single dose
Amoxicillin treatment.
2. Importance :
Evaluating the efficacy of single dose Amoxicillin treatment in previous studies
based on culture test results, and adverse events. Culture after treatment does not
accurately report the presence of pathogens because the suppressive effect of
antibiotics.
3. Applicability :
The study may be or may not be applicable on clinical practice. Single dose oral
regiments improved patient’s adherence but clinicians must also consider the
burden associated with an increase in the dosage per time in pediatric patients.