From the Guidelines
Yes, a daily dose of 1000 mg of amoxicillin for 10 days is an appropriate treatment protocol for streptococcal pharyngitis, as it is considered an acceptable alternative to the traditional twice-daily dosing regimen. The standard treatment for strep throat typically involves amoxicillin 500 mg twice daily for 10 days (total daily dose of 1000 mg), but research has shown that the once-daily dosing of 1000 mg provides similar efficacy 1. This works because amoxicillin has time-dependent bactericidal activity, and maintaining adequate blood levels over 24 hours is more important than peak concentrations.
Key Considerations
- The Infectious Diseases Society of America recommends amoxicillin as an acceptable alternative to penicillin V for the treatment of streptococcal pharyngitis, with a dosage of 50 mg/kg once daily (max = 1000 mg) for 10 days 1.
- The American Heart Association also supports the use of amoxicillin for the treatment of streptococcal pharyngitis, with a recommended dosage of 50 mg/kg (max = 1000 mg) once daily for 10 days 1.
- For optimal results, patients should take the medication at approximately the same time each day, complete the full 10-day course even if symptoms improve earlier, and take it with food if stomach upset occurs.
Treatment Duration and Efficacy
- The 10-day duration is specifically recommended to ensure complete eradication of Group A Streptococcus and to prevent complications such as rheumatic fever, even though symptoms typically improve within the first few days of treatment 1.
- The efficacy of amoxicillin in treating streptococcal pharyngitis has been demonstrated in several studies, with once-daily dosing regimens showing similar efficacy to traditional twice-daily dosing regimens 1.
From the FDA Drug Label
It is recommended that there be at least 10 days’ treatment for any infection caused by Streptococcus pyogenes to prevent the occurrence of acute rheumatic fever. Table 1 (12 weeks) n 40 kg Recommended Dosage for Pediatric Patients Aged 3 Months and Older and Weight Less than 40 kg Ear/Nose/Throat Mild/ Moderate 500 mg every 12 hours or 250 mg every 8 hours Severe 875 mg every 12 hours or 500 mg every 8 hours
The recommended dosage for Streptococcal pharyngitis is not explicitly stated as 1000 mg per day. The dosages listed for ear/nose/throat infections are:
- Mild/Moderate: 500 mg every 12 hours or 250 mg every 8 hours
- Severe: 875 mg every 12 hours or 500 mg every 8 hours A daily dose of 1000 mg of amoxicillin for 10 days is not a recommended treatment protocol according to the provided drug label 2 and 2.
From the Research
Treatment Protocol for Streptococcal Pharyngitis
- The standard therapy for streptococcal pharyngitis is penicillin V for 10 days, but there are drawbacks to this treatment, including the length of the dosing regimen and bacteriologic treatment failures 3.
- Alternative treatments, such as azithromycin, have been studied, but the optimal treatment regimen is still being researched 3, 4.
- Once-daily amoxicillin therapy has been shown to be effective in the treatment of streptococcal pharyngitis, with studies demonstrating similar rates of bacteriologic success compared to conventional therapy 5, 6.
Amoxicillin Dosage and Duration
- A study published in 2006 found that once-daily amoxicillin (750 mg or 1000 mg) for 10 days was not inferior to twice-daily amoxicillin in the treatment of streptococcal pharyngitis 5.
- Another study published in 1999 found that once-daily amoxicillin (750 mg) for 10 days was as effective as penicillin V (250 mg three times a day) in the treatment of streptococcal pharyngitis 6.
Comparison to Other Treatments
- A study published in 2001 compared the effectiveness of 10 days of clarithromycin and 5 days of azithromycin in eradicating group A streptococci from the throats of individuals with symptomatic pharyngitis, and found that the 10-day course of clarithromycin was more effective 7.
- The same study found that more than 97% of all streptococcal isolates were macrolide-sensitive, but the difference in eradication rates between the two macrolides could not be determined 7.