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) - Summary - 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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Objective:

To assess the effectiveness and tolerability of cephalexin-clavulanate compared to co-amoxiclav and azithromycin in adult patients with acute bacterial pharyngitis.

Approach:
  • Study Design: Retrospective, multicenter, comparative observational study analyzing electronic medical records of adults with clinically suspected acute bacterial pharyngitis.
  • Patient Selection: Included adults treated with study medications between November 2022 and March 2023, excluding those with incomplete records, hospitalizations, or requiring parenteral antibiotics.
  • Outcomes: Primary outcomes included clinical cure rates by Day 10; secondary outcomes included time to clinical improvement and adverse events.
Key Findings:
  • 752 patients analyzed: cephalexin-CV (n = 285), co-amoxiclav (n = 245), azithromycin (n = 222).
  • Overall clinical cure rates and time to improvement were similar across all groups.
  • Cephalexin-CV showed earlier clinical improvement by Day 2 (27% vs. 18% for co-amoxiclav, p = 0.035; 15% for azithromycin, p = 0.003) and Day 3 (58% vs. 47% for co-amoxiclav, p = 0.022; 48% for azithromycin, p = 0.071).
  • NSAID requirements were similar for cephalexin-CV and co-amoxiclav (46% each) but higher for azithromycin (57%, p = 0.020).
  • Adverse events were minimal across all groups.
Interpretation:

No statistically significant differences in overall clinical outcomes or tolerability among the three treatment groups, but cephalexin-CV was associated with earlier symptom improvement and lower NSAID use.

Limitations:
  • Retrospective design may introduce bias.
  • Data limited to a specific geographic region in India.
Conclusion:

Cephalexin-CV may offer early symptomatic relief and reduced NSAID requirements, making it a potential option for treating pharyngitis.

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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