What is the recommended dosage of amoxicillin for an adult with confirmed strep throat?

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Last updated: September 24, 2025View editorial policy

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Amoxicillin Dosage for Adult Strep Throat

For adults with confirmed strep throat, the recommended dosage of amoxicillin is 500 mg twice daily for 10 days. 1

Treatment Algorithm for Strep Throat in Adults

First-Line Treatment

  • Medication: Amoxicillin
  • Dosage: 500 mg twice daily
  • Duration: 10 days
  • Rationale: The Infectious Diseases Society of America recommends a full 10-day course to ensure bacterial eradication and prevent complications 1

Alternative Regimens (for penicillin-allergic patients)

  • Azithromycin: 500 mg once daily for 5 days
  • Clindamycin: 300-450 mg orally three times daily for 10 days 1

Important Clinical Considerations

Duration of Treatment

  • The full 10-day course must be completed even if symptoms improve
  • Not completing the full course increases risk of rheumatic fever 1
  • Patients are considered non-contagious after 24 hours of effective antibiotic therapy 1

Symptom Management

  • Ibuprofen or acetaminophen for pain and fever relief
  • Maintain adequate hydration
  • Avoid aspirin in children due to risk of Reye syndrome 1

Return to Work/School

  • Patients may return to work after completing 24 hours of appropriate antibiotic therapy, provided they are feeling well enough and fever has resolved 1

Monitoring and Follow-Up

When to Reassess

  • Evaluate for treatment failure if symptoms worsen or do not improve after 48-72 hours of antibiotic therapy 1
  • Follow-up throat cultures are not routinely indicated for asymptomatic patients who have completed appropriate therapy 1

Prevention of Spread

  • Hand hygiene
  • Avoid close contact with infected individuals
  • Do not share utensils or drinks 1

Special Considerations

Recurrent Episodes

  • Evaluate whether the patient is experiencing multiple true GAS infections or is a chronic carrier with viral infections 1

Antibiotic Resistance

  • In areas with high resistance rates, susceptibility testing should be considered 1

While the FDA label for amoxicillin 2 provides general dosing information for upper respiratory tract infections (750 to 1750 mg/day in divided doses every 8 to 12 hours), the more specific recommendation from the Infectious Diseases Society of America for strep throat is 500 mg twice daily for 10 days, which falls within this range and has demonstrated efficacy in clinical practice.

References

Guideline

Antibiotic Treatment for Strep Throat

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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