Treatment
Table 3. Antibiotic Regimens Recommended for Group A
Streptococcal Pharyngitis
Drug, Route
Dosage
Duration
Rating
Penicillin V generic, oral
Children: 250 mg bid or tid
Adolescents tid
Adults: 250 mg qid or 500 mg bid
10 days
SR-H
Amoxicillin generic, oral
50 mg/kg once daily (Max = 1000
mg)
Alternate: 25 mg/kg bid ���
(Max = 500 mg) bid
10 days
SR-H
Benzathine penicillin G
generic, IM
< 27 kg: 600,000 units
��� 27 kg: 1.2 million units
one dose
SR-H
For Penicillin-Allergic Individuals
Cephalexin Keflex��a PO
20 mg/kg/dose bid ���
(Max = 500 mg/dose)
10 days
SR-H
Cefadroxila Duricef ��,
Ultracef �� PO
30 mg/kg daily ���
(Max = 1 gm)
10 days
SR-H
Clindamycin Cleocin�� PO
7 mg/kg/dose tid ���
(Max = 300 mg/dose)
10 days
SR-M
Azithromycinb Zithromax�� PO
12 mg/kg daily (Max = 500 mg)
5 days
SR-M
Clarithromycinb Biaxin�� PO
7.5 mg/kg/dose bid ���
(Max = 250 mg/dose)
10 days
SR-M
a
b
Avoid in those with immediate type hypersensitivity to penicillin
Resistance of GAS to these agents is well-known and varies geographically and temporally
Table 4. Treatment Regimens for Chronic GAS Carriers
Route Agent
Oral Clindamycin Cleocin��
Dosage
Duration
Rating
20-30 mg/kg/d in 3 doses
(Max = 300 mg/dose)
10 days
SR-H
Penicillin and Rifampin
Rifadin��, Rimactane��
Pen V:
50 mg/kg/d in 4 doses x10 days
(Max = 2000 mg/d)
Rifampin:
20 mg/kg/d in 1 dose
x last 4 days of treatment
(Max = 600 mg/d)
10 days
SR-H
Amoxicillin-clavulanic
acid Augmentin��
40 mg amoxicillin /kg/d in 3 doses
(Max = 2000 mg amoxicillin/d)
10 days
SR-M
1 dose
SR-H
IM & Oral
IM
PO
Benzathine penicillin G Penicillin:
PLUS
600,000 units for < 27 kg
Rifampin
1,200,000 units for ��� 27 kg
Rifampin:
20 mg/kg/d in 2 doses ���
(Max = 600 mg/d)
4 days
