From the Guidelines
Amoxicillin should not be restarted after a pause in treatment for strep tonsillitis, and instead, the full 10-day course should be completed without interruption. The recommended approach for Group A Streptococcal pharyngitis (strep throat) is to complete the full course of antibiotics, typically 10 days, as outlined in the guidelines by the Infectious Diseases Society of America 1. If treatment was interrupted after 5 days, it's best to consult with a healthcare provider about how to proceed. They may recommend starting a new complete 10-day course of amoxicillin (typically 50 mg/kg once daily, with a maximum of 1000 mg, for 10 days) or possibly switching to a different antibiotic.
Interrupting antibiotic therapy can lead to incomplete eradication of the bacteria, potentially causing treatment failure, symptom recurrence, or contributing to antibiotic resistance. The 10-day duration for strep throat treatment is specifically designed to ensure complete bacterial elimination and prevent complications like rheumatic fever, even if symptoms improve earlier. Key considerations include:
- The importance of completing the full antibiotic course to prevent treatment failure and complications.
- The potential for antibiotic resistance with incomplete treatment courses.
- The need for personalized guidance from a healthcare provider if treatment was interrupted.
Given the potential risks associated with incomplete treatment, it is crucial to follow the recommended guidelines for antibiotic therapy in strep throat, as supported by the evidence from the Infectious Diseases Society of America 1. If you've already had a pause in treatment, contact your healthcare provider promptly for personalized guidance rather than self-restarting the medication.
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. Treatment should be continued for a minimum of 48 to 72 hours beyond the time that the patient becomes asymptomatic, or evidence of bacterial eradication has been obtained.
The patient should complete a full 10-day course of amoxicillin to ensure proper treatment of the strep tonsillitis infection, as the initial 5-day course is not sufficient. The few days pause does not negate the need for a full course, and restarting amoxicillin for another 5 days is recommended to complete the 10-day treatment regimen, as indicated for infections caused by Streptococcus pyogenes 2.
From the Research
Amoxicillin Treatment for Strep Tonsillitis
- The standard treatment for strep tonsillitis is a 10-day course of antibiotics, such as penicillin or amoxicillin 3, 4.
- There is no clear evidence to support restarting a 5-day course of amoxicillin after a few days' pause for another 5 days 5, 6, 7.
- A study comparing a 5-day course of cefuroxime axetil with a 10-day course of penicillin V found that the shorter course was at least as effective as the longer course in eradicating the infection 5.
- However, another study found that a 10-day course of penicillin or amoxicillin is still recommended as the first-line treatment for strep tonsillitis, due to the low cost and absence of resistance 7.
- It is essential to complete the full course of antibiotics as prescribed by a healthcare professional to ensure effective treatment and prevent complications 3, 4.
Considerations for Treatment
- The choice of antibiotic and duration of treatment should be based on the individual patient's needs and medical history 6, 7.
- Amoxicillin is a commonly used antibiotic for treating strep tonsillitis, but it is crucial to follow the prescribed treatment regimen and complete the full course of antibiotics 3, 4.
- If symptoms persist or worsen after completing the treatment, patients should be reevaluated by a healthcare professional to determine the best course of action 3.