Template:Streptococcal Pharyngitis Antibiotics

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):

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