Template:Streptococcal Pharyngitis Antibiotics: Difference between revisions
(Fix Cefuroxime dose: 200mg (was from Cefditoren data) -> 250mg PO bid (correct Cefuroxime dose)) |
(Add explicit pediatric dosing section for Streptococcal pharyngitis) |
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*{{AntibioticDose|disease=Streptococcal pharyngitis|drug=Azithromycin|dose=12 mg/kg PO once (maximum = 500 mg), then 6 mg/kg (max=250 mg) once daily for the next 4 days|context=Penicillin Allergy (anaphylaxis)}}<ref>CDC Website, accessed 2026-28-01. https://www.cdc.gov/group-a-strep/hcp/clinical-guidance/strep-throat.html</ref> | *{{AntibioticDose|disease=Streptococcal pharyngitis|drug=Azithromycin|dose=12 mg/kg PO once (maximum = 500 mg), then 6 mg/kg (max=250 mg) once daily for the next 4 days|context=Penicillin Allergy (anaphylaxis)}}<ref>CDC Website, accessed 2026-28-01. https://www.cdc.gov/group-a-strep/hcp/clinical-guidance/strep-throat.html</ref> | ||
*{{AntibioticDose|disease=Streptococcal pharyngitis|drug=Clarithromycin|dose=7.5 mg/kg/dose PO BID (maximum = 250 mg/dose) x 10 days|context=Penicillin Allergy (anaphylaxis)}}<ref>CDC Website, accessed 2026-28-01. https://www.cdc.gov/group-a-strep/hcp/clinical-guidance/strep-throat.html</ref> | *{{AntibioticDose|disease=Streptococcal pharyngitis|drug=Clarithromycin|dose=7.5 mg/kg/dose PO BID (maximum = 250 mg/dose) x 10 days|context=Penicillin Allergy (anaphylaxis)}}<ref>CDC Website, accessed 2026-28-01. https://www.cdc.gov/group-a-strep/hcp/clinical-guidance/strep-throat.html</ref> | ||
'''Pediatric Dosing:''' | |||
*{{AntibioticDose|disease=Streptococcal pharyngitis|drug=Amoxicillin|dose=50mg/kg PO once daily x 10 days (max 1000mg)|context=Pediatric First Line|population=Pediatric}} | |||
*{{AntibioticDose|disease=Streptococcal pharyngitis|drug=Penicillin V|dose=<27kg: 250mg PO BID-TID x 10 days; >27kg: 500mg PO BID-TID x 10 days|context=Pediatric First Line|population=Pediatric}} | |||
*{{AntibioticDose|disease=Streptococcal pharyngitis|drug=Penicillin G Benzathine|dose=<27kg: 600,000 units IM x 1; >27kg: 1.2 million units IM x 1|context=Pediatric First Line|population=Pediatric}} | |||
*PCN allergy (mild): {{AntibioticDose|disease=Streptococcal pharyngitis|drug=Cephalexin|dose=20mg/kg PO BID x 10 days (max 500mg/dose)|context=Pediatric PCN Allergy|population=Pediatric}} | |||
*PCN allergy (mild): {{AntibioticDose|disease=Streptococcal pharyngitis|drug=Cefadroxil|dose=30mg/kg PO daily x 10 days (max 1g)|context=Pediatric PCN Allergy|population=Pediatric}} | |||
*PCN allergy (severe): {{AntibioticDose|disease=Streptococcal pharyngitis|drug=Azithromycin|dose=12mg/kg PO day 1 (max 500mg), then 6mg/kg daily x 4 days (max 250mg)|context=Pediatric PCN Allergy (severe)|population=Pediatric}} | |||
*PCN allergy (severe): {{AntibioticDose|disease=Streptococcal pharyngitis|drug=Clindamycin|dose=7mg/kg/dose PO TID x 10 days (max 300mg/dose)|context=Pediatric PCN Allergy (severe)|population=Pediatric}} | |||
*PCN allergy (severe): {{AntibioticDose|disease=Streptococcal pharyngitis|drug=Clarithromycin|dose=7.5mg/kg PO BID x 10 days (max 250mg/dose)|context=Pediatric PCN Allergy (severe)|population=Pediatric}} | |||
*{{AntibioticDose|drug=Clindamycin|dose=7mg/kg/dose PO q8h x 10 days<ref>CDC Website, accessed 2026-28-01. https://www.cdc.gov/group-a-strep/hcp/clinical-guidance/strep-throat.html</ref>; Max: 300mg/dose|context=Streptococcal Pharyngitis|disease=Pharyngitis|population=Pediatric}} | *{{AntibioticDose|drug=Clindamycin|dose=7mg/kg/dose PO q8h x 10 days<ref>CDC Website, accessed 2026-28-01. https://www.cdc.gov/group-a-strep/hcp/clinical-guidance/strep-throat.html</ref>; Max: 300mg/dose|context=Streptococcal Pharyngitis|disease=Pharyngitis|population=Pediatric}} | ||
*{{AntibioticDose|drug=Azithromycin|dose=Children ≥2 years and Adolescents: Oral: 12mg/kg/dose once daily for 5 days (maximum: 500mg daily)|context=Pharyngitis (as an alternative agent in penicillin allergic patients)|disease=Pharyngitis|population=Pediatric}} | *{{AntibioticDose|drug=Azithromycin|dose=Children ≥2 years and Adolescents: Oral: 12mg/kg/dose once daily for 5 days (maximum: 500mg daily)|context=Pharyngitis (as an alternative agent in penicillin allergic patients)|disease=Pharyngitis|population=Pediatric}} | ||
Latest revision as of 12:56, 20 March 2026
Treatment can be delayed for up to 9 days and still prevent major sequelae
Penicillin Options:
- Penicillin V 250mg PO BID x 10d (child) or 500mg BID x 10d (adolescent or adult)[1][2]
- Bicillin L-A <27 kg: 0.6 million units; ≥27 kg: 1.2 million units IM x 1[1][3]
- Amoxicillin 50 mg/kg once daily (maximum = 1000 mg) for 10 days[4]
Penicillin allergic (mild):
- Cephalexin 20 mg per kg PO BID (maximum 500 mg per dose) x 10 days[5]
- Cefadroxil 30 mg per kg PO QD (maximum 1 g daily) x 10 days[6]
Penicillin allergic (anaphylaxis):[1]
- Clindamycin 7 mg/kg/dose TID (maximum = 300 mg/dose) x 10 days[7]
- Azithromycin 12 mg/kg PO once (maximum = 500 mg), then 6 mg/kg (max=250 mg) once daily for the next 4 days[8]
- Clarithromycin 7.5 mg/kg/dose PO BID (maximum = 250 mg/dose) x 10 days[9]
Pediatric Dosing:
- Amoxicillin 50mg/kg PO once daily x 10 days (max 1000mg)
- Penicillin V <27kg: 250mg PO BID-TID x 10 days; >27kg: 500mg PO BID-TID x 10 days
- Penicillin G Benzathine <27kg: 600,000 units IM x 1; >27kg: 1.2 million units IM x 1
- PCN allergy (mild): Cephalexin 20mg/kg PO BID x 10 days (max 500mg/dose)
- PCN allergy (mild): Cefadroxil 30mg/kg PO daily x 10 days (max 1g)
- PCN allergy (severe): Azithromycin 12mg/kg PO day 1 (max 500mg), then 6mg/kg daily x 4 days (max 250mg)
- PCN allergy (severe): Clindamycin 7mg/kg/dose PO TID x 10 days (max 300mg/dose)
- PCN allergy (severe): Clarithromycin 7.5mg/kg PO BID x 10 days (max 250mg/dose)
- Clindamycin 7mg/kg/dose PO q8h x 10 days[10]; Max: 300mg/dose
- Azithromycin Children ≥2 years and Adolescents: Oral: 12mg/kg/dose once daily for 5 days (maximum: 500mg daily)
- Amoxicillin 50mg/kg PO q24h x 10 days[11]; Max: 1000mg/day
- Clarithromycin >6mo: 15mg/kg/day PO divided q12h x 7-10d
- Cephalexin 40mg/kg/day PO divided q12h x 10 days; Max: 500mg/dose
- Cefpodoxime 100mg q 12 h for 5-10 days
- Cefuroxime 250mg PO bid x10 days
- Cefuroxime 250mg PO bid x10 days
- ↑ 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
- ↑ CDC Website, accessed 2026-28-01. https://www.cdc.gov/group-a-strep/hcp/clinical-guidance/strep-throat.html
- ↑ CDC Website, accessed 2026-28-01. https://www.cdc.gov/group-a-strep/hcp/clinical-guidance/strep-throat.html
- ↑ CDC Website, accessed 2026-28-01. https://www.cdc.gov/group-a-strep/hcp/clinical-guidance/strep-throat.html
- ↑ CDC Website, accessed 2026-28-01. https://www.cdc.gov/group-a-strep/hcp/clinical-guidance/strep-throat.html
- ↑ CDC Website, accessed 2026-28-01. https://www.cdc.gov/group-a-strep/hcp/clinical-guidance/strep-throat.html
- ↑ CDC Website, accessed 2026-28-01. https://www.cdc.gov/group-a-strep/hcp/clinical-guidance/strep-throat.html
- ↑ CDC Website, accessed 2026-28-01. https://www.cdc.gov/group-a-strep/hcp/clinical-guidance/strep-throat.html
- ↑ CDC Website, accessed 2026-28-01. https://www.cdc.gov/group-a-strep/hcp/clinical-guidance/strep-throat.html
- ↑ CDC Website, accessed 2026-28-01. https://www.cdc.gov/group-a-strep/hcp/clinical-guidance/strep-throat.html
- ↑ CDC Website, accessed 2026-28-01. https://www.cdc.gov/group-a-strep/hcp/clinical-guidance/strep-throat.html