TABLE 27-2.
Antimicrobial Therapy for Group A β-Hemolytic Streptococci (GAS) Pharyngitis
| Route of Administration, Antimicrobial Agent | Dosage | Duration |
|---|---|---|
| Oral | ||
| Penicillin | Children: 250 mg bid or tid | 10 days |
| Adolescents and adults: 250 mg tid or qid | 10 days | |
| Adolescents and adults: 500 mg bid | 10 days | |
| Intramuscular | ||
| Benzathine penicillin G | 6.0 × 105 U (for patients ≤27 kg) | 1 dose |
| 1.2 × 106 U (for patients >27 kg) | 1 dose | |
| Mixtures of benzathine and procaine penicillin G | Varies with formulationa | |
| Oral, for patients allergic to penicillin | ||
| Erythromycin | Varies with formulation | 10 days |
| First-generation cephalosporinsb | Varies with agent | 10 days |
bid, twice daily; tid, three times daily; qid, four times daily.
a
Dose should be determined on basis of benzathine component.
b
These agents should not be used to treat patients with immediate-type hypersensitivity to β-lactam antibiotics.
Modified from Bisno AL, Gerber MA, Gwaltney JM, et al. Practice guideline for the diagnosis and management of group A streptococcal pharyngitis. Clin Infect Dis 2002;35:113–125, with permission.