From the Research
Rectal strep infection (Group A Streptococcus in the rectum) should be treated with antibiotics, typically penicillin or amoxicillin, as the most recent and highest quality study suggests that penicillin and amoxicillin are the first-line antibiotics for treating streptococcal pharyngitis 1.
Treatment Recommendations
For adults, the standard treatment is penicillin V 500 mg orally twice daily for 10 days, or amoxicillin 500 mg three times daily for 10 days.
- For children, amoxicillin 50 mg/kg/day divided into two or three doses for 10 days is recommended.
- If the patient has a penicillin allergy, alternatives include clindamycin 300 mg three times daily for adults or 20-30 mg/kg/day divided into three doses for children, or azithromycin 500 mg on day one followed by 250 mg daily for four more days for adults (or 12 mg/kg/day for children) 2.
Importance of Completing Treatment
It's essential to complete the full course of antibiotics even if symptoms improve before finishing the medication, as this ensures that the infection is fully cleared and reduces the risk of complications.
Preventing Spread and Symptomatic Relief
During treatment, maintaining good hygiene, including proper handwashing and avoiding sharing personal items, helps prevent spreading the infection to others.
- Warm sitz baths can provide symptomatic relief.
Follow-up
Rectal strep infections require treatment because the bacteria can cause complications if left untreated, including potential spread to other body sites or to other individuals.
- Follow-up with a healthcare provider is recommended if symptoms don't improve within 48-72 hours of starting antibiotics 3.