. 2009 May 18:453–480. doi: 10.1016/B978-032304048-8.50036-0

Table 32-1.

Antimicrobial Therapy for Streptococcus pyogenes 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	1.2 × 10⁶ U (for patients ≥27 kg)	1 dose
	6.0 × 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 days
First-generation cephalosporin^‡	Varies with agent	10 days

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.

Modified from Gerber MA: Diagnosis and treatment of pharyngitis in children. Pediatr Clin North Am 52:729-747, 2005; and Bisno AL, Gerber MA, Gwaltney JM, et al: Practice guidelines for the diagnosis and management of group A streptococcal pharyngitis. Clin Infect Dis 35:113-125, 2002.