Table 1.

Antibiotic options for treatment of GAS pharyngitis.

Initial and recurrent episodes	Dose and duration	Considerations
PenicillinⅤ (oral)	If ≤ 27 kg: 250 mg per dose, two to three times daily for 10 days If > 27 kg: 500 mg per dose, two to three times daily for 10 days	Preferred therapy
Amoxicillin	50 mg/kg once daily for 10 days; max dose 1000 mg	Preferred therapy
Penicillin G benzathine (IM)	If < 27 kg: 600,000 U (375 mg) as single dose If ≥ 27 kg: 1.2 million U (750 mg) intramuscular as single dose	Preferred therapy in situations of poor medication adherence
Cephalexin	40 mg/(kg·d) divided twice daily for 10 days; max dose 500 mg	Alternative therapy for children with non-anaphylactic penicillin allergy
Clindamycin	20 mg/(kg·d) divided three times daily for 10 days; max dose 300 mg	Alternative therapy for children with anaphylactic penicillin allergy. Consider testing to confirm susceptibility.
Azithromycin	12 mg/kg once on day 1 followed by 6 mg/kg once daily on days 2∼5; max dose 500 mg	Alternative therapy for children with anaphylactic penicillin allergy. Consider testing to confirm susceptibility.
Chronic pharyngeal carriage	Dose and duration	Considerations
Clindamycin	20∼30 mg/(kg·d) divided three times daily for 10 days	Consider testing to confirm susceptibility.
Penicillin V and rifampin	Penicillin Ⅴ: 50 mg/(kg·d) divided four times daily for 10 days; max 2000 mg/day rifampin: 20 mg/(kg·d) once daily for last 4 days of treatment; max 600 mg/day	–
Amoxicillin/clavulanate	Amoxicillin：40 mg/(kg·d) divided three times daily; max 2000 mg amoxicillin/day	–

IM: Intramuscular injection.