From the Guidelines
The treatment for Streptococcal pharyngitis (strep throat) is penicillin, specifically penicillin V (phenoxymethylpenicillin) 250-500 mg orally 2-4 times daily for 10 days, or amoxicillin 50 mg/kg once daily (maximum 1 g) for 10 days, as recommended by the American Heart Association 1. The choice of antibiotic depends on the patient's age, weight, and allergy history. For patients with penicillin allergies, alternatives include narrow-spectrum cephalosporins, clindamycin, or macrolides such as azithromycin. Some key points to consider when treating strep throat include:
- Completing the full course of antibiotics, even if symptoms improve before completion, to prevent recurrence and complications
- Using supportive care such as adequate hydration, rest, and over-the-counter pain relievers like acetaminophen or ibuprofen for fever and throat pain
- Being aware of the potential for antibiotic resistance and the importance of proper antibiotic use
- Considering the patient's individual needs and medical history when selecting an antibiotic regimen, as recommended by the Infectious Diseases Society of America 1. It's also important to note that strep throat is typically a self-limited disease, and symptoms such as fever and throat pain usually resolve on their own within 3-4 days, even without antibiotic treatment 1. However, prompt treatment with antibiotics is still important to prevent complications such as rheumatic fever or kidney inflammation, which can occur if the infection is left untreated or not fully treated. Overall, the goal of treatment for strep throat is to eradicate the infection, prevent complications, and improve symptoms, while also considering the patient's individual needs and medical history.
From the FDA Drug Label
In streptococcal infections, therapy must be sufficient to eliminate the organism (10-day minimum); otherwise the sequelae of streptococcal disease may occur. NOTE: Penicillin by the intramuscular route is the usual drug of choice in the treatment of Streptococcus pyogenes infection and the prophylaxis of rheumatic fever. Pharyngitis/tonsillitis caused by Streptococcus pyogenes as an alternative to first-line therapy in individuals who cannot use first-line therapy.
The treatment for Streptococcal pharyngitis (strep throat) is:
- Penicillin (by the intramuscular route) for a minimum of 10 days to eliminate the organism and prevent sequelae of streptococcal disease 2
- Azithromycin as an alternative to first-line therapy in individuals who cannot use first-line therapy 3
From the Research
Treatment Options for Streptococcal Pharyngitis
- The treatment for streptococcal pharyngitis typically involves antibiotics, with penicillin being the most commonly recommended option 4, 5, 6, 7.
- Erythromycin is also effective in treating streptococcal pharyngitis, particularly in patients who are allergic to penicillin 4, 6.
- Cephalosporins have been shown to be effective in treating streptococcal pharyngitis, especially in cases of recurrent infections 5, 6.
- The duration of treatment is typically 10 days, although some studies suggest that shorter courses of antibiotic therapy may be effective in some cases 8.
Antibiotic Dosage and Frequency
- The recommended dosage of penicillin V for treating streptococcal pharyngitis is 250-500 mg, taken 2-4 times daily for 10 days 4, 7.
- Erythromycin estolate may be given in two, three, or four daily doses, with a recommended daily dosage of 20-30 mg/kg/day 4.
- Cephalosporins may be given in shorter courses, such as 4-5 days, and have been shown to be effective in treating streptococcal pharyngitis 5, 8.