Table 3.
Antimicrobial therapy for group A streptococcal pharyngitis
| Route of administration, antimicrobial agent | Dosage | Duration |
|---|---|---|
| Oral | ||
| Penicillin* | Children: 250 mg bid or tid | 10 d |
| Adolescents and adults: 250 mg tid or qid | 10 d | |
| Adolescents and adults: 500 mg bid | 10 d | |
| Intramuscular | ||
| Benzathine penicillin G | 1.2 × 106 U (for patients ≥27 kg) | 1 dose |
| 6 × 105 U (for patients <27 kg) | 1 dose | |
| Mixtures of benzathine and procaine penicillin G | Varies with formulation† | 1 dose |
| Oral, for patients allergic to penicillin | ||
| Erythromycin | Varies with formulation | 10 d |
| First-generation cephalosporins‡ | Varies with agent | 10 d |
Modified from Bisno AL, Gerber MA, Gwaltney JM, Kaplan EL, Schwartz RH. Practice guideline for the diagnosis and management of group A streptococcal pharyngitis. Clin Infect Dis 2002;35:113–25.
*
Amoxicillin is often used in place of oral penicillin V in young children because of the acceptance of the taste of the suspension, not because of any microbiologic advantage.
†
Dose should be determined on basis of benzathine component.
‡
These agents should not be used to treat patients with immediate-type hypersensitivity to β-lactam antibiotics.