From the Guidelines
Yes, beta-hemolytic Group C Streptococcus can be effectively treated with amoxicillin. The typical adult dosage is 500 mg orally three times daily for 10 days, or alternatively, 875 mg twice daily for 10 days [ 1 ]. For children, the recommended dose is 45-50 mg/kg/day divided into two doses for 10 days. Amoxicillin is considered a first-line treatment because Group C streptococci remain highly susceptible to penicillins [ 1 ]. The medication works by inhibiting bacterial cell wall synthesis, leading to cell death.
Key Considerations
- For patients with penicillin allergy, alternatives include clindamycin (300-450 mg orally three times daily for adults) or azithromycin (500 mg on day 1, then 250 mg daily for 4 more days) [ 1 ].
- It's essential to complete the full course of antibiotics even if symptoms improve before completion to ensure complete eradication of the bacteria and prevent complications or recurrence.
- Adequate hydration and rest are also recommended during treatment.
Treatment Approach
- The choice of treatment should be based on the severity of the infection, patient's medical history, and susceptibility of the bacteria to antibiotics.
- In general, strains of group B, C, F, and G streptococci are slightly more resistant to penicillin than are strains of group A streptococci [ 1 ].
- The addition of gentamicin to penicillin or to ceftriaxone for at least the first 2 weeks of a 4- to 6-week course of antimicrobial therapy for group B, C, and G streptococcal IE may be considered [ 1 ].
From the FDA Drug Label
Amoxicillin for oral suspension is indicated in the treatment of infections due to susceptible (ONLY β-lactamase–negative) isolates of Streptococcusspecies. (α-and β-hemolytic isolates only)
The FDA drug label does not specifically mention Streptococcus group C. It mentions Streptococcus species with α-and β-hemolytic isolates only, but it does not provide information on specific groups, such as group C. Therefore, no conclusion can be drawn about the effectiveness of amoxicillin against beta-hemolytic Streptococcus (Strep) group C 2.
From the Research
Treatment of Beta-Hemolytic Streptococcus Group C
- Beta-hemolytic Streptococcus group C can be treated with various antibiotics, including beta-lactam antibiotics 3.
- According to a study, all group C streptococcal isolates were susceptible to third and fourth-generation cephalosporins, imipenem, chloramphenicol, rifampin, teicoplanin, and vancomycin 3.
- The study also found that 2 group C strains were resistant to oxacillin and showed intermediate susceptibility to penicillin G 3.
- Another study found that all beta-hemolytic streptococci, including group C, were susceptible to penicillin, amoxycillin, cephalosporins, and linezolid 4.
- Amoxicillin is a beta-lactam antibiotic that can be used to treat beta-hemolytic Streptococcus group C infections, as it is susceptible to this type of antibiotic 3, 4.
Comparison of Antibiotics
- A study compared the clinical and bacteriologic efficacy and tolerability of oral clindamycin with those of oral amoxicillin/clavulanic acid in the outpatient treatment of acute recurrent group A beta-hemolytic streptococcal pharyngotonsillitis 5.
- The study found that both treatments achieved comparable rates of bacteriologic eradication at 12 days and 3 months and comparable clinical cure rates at 3 months 5.
- Patients who received clindamycin had significantly greater clinical cure rates at 12 days 5.
- Another study found that resistance to erythromycin, tetracycline, clindamycin, chloramphenicol, and quinolones is emerging among beta-hemolytic streptococci 4.
Route of Antibiotic Administration
- A study compared oral and intravenous definitive antibiotic therapy for beta-hemolytic streptococcal bloodstream infections from soft tissue sources 6.
- The study found that patients who transitioned to oral antibiotics by day 7 showed higher rates of 30-day treatment failure than propensity-matched patients who continued intravenous therapy 6.