Effectiveness and tolerability of cephalexin and clavulanic acid fixed dose combination, amoxicillin and clavulanic acid fixed dose combination, and azithromycin in patients with pharyngitis in India: a real-world retrospective study from electronic medical records (PHARYSPOR) - Report - MDSpire

Effectiveness and tolerability of cephalexin and clavulanic acid fixed dose combination, amoxicillin and clavulanic acid fixed dose combination, and azithromycin in patients with pharyngitis in India: a real-world retrospective study from electronic medical records (PHARYSPOR)

  • By

  • Subramanyam Sarof

  • Nikita Kariappa Somana

  • Ravindra Channagiri S

  • Ramesh Chinthalapalli Venkataram

  • Jyothi Sharma R

  • Sabhapathi SV

  • Ramakrishnaiah Peddi

  • Sadanandam K

  • Nitin Rai Vohra

  • Lokesh Kumar Bhama

  • Mahendrakumar Shah

  • Vijay Chile

  • Ameeta Gunderia

  • Farad Momin

  • Anit Banerjee

  • Saumitra Kumar

  • Sandeep Rungta

  • Ashik Ikbal

  • Sunil Singhvi

  • Annamalai Natarajan

  • Monjori Mitra

  • Vijay Kadam

  • Shruti Dharmadhikari

  • Chintan Khandhedia

  • Gaurav Puppalwar

  • Neeraj Markandeywar

  • Amey Mane

  • Suyog Mehta

  • July 9, 2026

  • 0 min

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Clinical Report: Comparative Analysis of Cephalexin-Clavulanate for Pharyngitis

Overview

This study evaluated the effectiveness and tolerability of cephalexin-clavulanate compared to co-amoxiclav and azithromycin in treating acute bacterial pharyngitis in Indian adults. Cephalexin-CV showed earlier clinical improvement and lower NSAID use.

Background

Acute pharyngitis is a prevalent condition that significantly impacts health-related quality of life and is often caused by bacterial infections. With rising antimicrobial resistance, it is crucial to assess new treatment options. The introduction of cephalexin-clavulanate as a fixed-dose combination has been approved in India for managing this condition.

Data Highlights

MedicationClinical Cure Rate by Day 10Clinical Improvement by Day 2NSAID Requirement
Cephalexin-CVSimilar27%46%
Co-AmoxiclavSimilar18%46%
AzithromycinSimilar15%57%

Key Findings

  • Cephalexin-CV demonstrated earlier clinical improvement by Day 2 compared to co-amoxiclav and azithromycin.
  • Overall clinical cure rates by Day 10 were similar across all treatment groups.
  • The requirement for NSAIDs was significantly higher in the azithromycin group.
  • Adverse events were minimal across all groups, with mild gastritis reported in the cephalexin-CV group.
  • This study utilized electronic medical records to analyze real-world outcomes in treating acute pharyngitis.

Clinical Implications

Clinicians should consider the findings of this study when prescribing treatment for acute bacterial pharyngitis.

Conclusion

The study did not demonstrate any statistically significant differences in overall clinical outcomes among patients with pharyngitis treated with cephalexin-CV, co-amoxiclav, or azithromycin.

Related Resources & Content

  1. Drugs - Real World Outcomes, 2023 -- Comparative Analysis of Oral Cephalexin-Clavulanic Acid, Cefuroxime, and Amoxicillin-Clavulanic Acid for Treating Dental Infections
  2. Drugs - Real World Outcomes, 2025 -- Safety and Effectiveness of a Fixed-Dose Combination of Cephalexin Extended Release and Clavulanate Potassium in Bacterial Sore Throat
  3. IDSA Clinical Practice Guideline Update on Group A Streptococcal (GAS) Pharyngitis
  4. Clinical Guidance for Group A Streptococcal Pharyngitis | Group A Strep | CDC
  5. Guidelines for Antimicrobial Use, ICMR
  6. Recommendations | Sore throat (acute): antimicrobial prescribing | Guidance | NICE
  7. Infection — Comparative Effectiveness of Ceftazidime-avibactam Alone or with Aztreonam Versus Polymyxins for Treating Carbapenem-Resistant Klebsiella pneumoniae Infections: Insights from the CAPRI Study in South India
  8. Open Forum Infectious Diseases — Determining Amoxicillin-Clavulanate Sensitivity Based on Ampicillin-Sulbactam Resistance in Common Enterobacterales Species
  9. IDSA Clinical Practice Guideline Update on Group A Streptococcal (GAS) Pharyngitis
  10. Clinical Guidance for Group A Streptococcal Pharyngitis | Group A Strep | CDC
  11. Guidelines for Antimicrobial Use
  12. Recommendations | Sore throat (acute): antimicrobial prescribing | Guidance | NICE
  13. Treatment of confirmed streptococcal pharyngitis and of sore throat with antibiotics: evidence update; Should all children, adolescents and adults presenting with sore throat be treated with antibiotics to prevent RF/RHD? - WHO guideline on the prevention and diagnosis of rheumatic fever and rheumatic heart disease - NCBI Bookshelf
  14. Frontiers | Efficacy and safety of 24 antibiotics for group A streptococcal pharyngitis: a network meta-analysis of 64 randomized controlled trials
  15. Different antibiotics for group A streptococcal pharyngitis | Cochrane
  16. https://cdsco.gov.in/opencms/resources/UploadCDSCOWeb/2018/UploadApprovalMarketingFDC/dcgiapprovalsep19.pdf

Original Source(s)

Effectiveness and tolerability of cephalexin and clavulanic acid fixed dose combination, amoxicillin and clavulanic acid fixed dose combination, and azithromycin in patients with pharyngitis in India: a real-world retrospective study from electronic medical records (PHARYSPOR)

  • by Subramanyam Sarof, Nikita Kariappa Somana, Ravindra Channagiri S, Ramesh Chinthalapalli Venkataram, Jyothi Sharma R, Sabhapathi SV, Ramakrishnaiah Peddi, Sadanandam K, Nitin Rai Vohra, Lokesh Kumar Bhama, Mahendrakumar Shah, Vijay Chile, Ameeta Gunderia, Farad Momin, Anit Banerjee, Saumitra Kumar, Sandeep Rungta, Ashik Ikbal, Sunil Singhvi, Annamalai Natarajan, Monjori Mitra, Vijay Kadam, Shruti Dharmadhikari, Chintan Khandhedia, Gaurav Puppalwar, Neeraj Markandeywar, Amey Mane, Suyog Mehta

  • July 9, 2026

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