Template:Streptococcal Pharyngitis Antibiotics

Treatment can be delayed for up to 9 days and still prevent major sequelae

Penicillin Options:[1]

  • Penicillin V 250mg PO BID x 10d (child) or 500mg BID x 10d (adolescent or adult)
  • Bicillin L-A <27 kg: 0.6 million units; ≥27 kg: 1.2 million units IM x 1
  • Amoxicillin 500-875 mg PO q12h or 250-500 PO q8h for 10d[2]

Penicillin allergic (mild):[1]

  • Cefuroxime 10mg/kg PO QID x 10d (child) or 250mg PO BID x 4d

Penicillin allergic (anaphylaxis):[1]

  • Clindamycin 7.5mg/kg PO QID x 10d (child) or 450mg PO TID x 10d OR
  • Azithromycin 12mg/kg QD (child) or 500mg on day 1; then 250mg on days 2-5
  • 1.0 1.1 1.2 Shulman, et al. Clinical Practice Guideline for the Diagnosis and Management of Group A Streptococcal Pharyngitis: 2012 Update by the Infectious Diseases Society of America. Clinical Infectious Diseases 2012;55(10):1279–82
  • Shah, U. K., MD. (2020, October 14). Tonsillitis and Pharyngitis Organism-Specific Therapy: Specific Organisms and Therapeutic Regimens. Emedicine. https://emedicine.medscape.com/article/2011872-overview