Will amoxicillin-clavulanate (Augmentin) treat streptococcal pharyngitis?

From the Guidelines

Augmentin (amoxicillin-clavulanate) is not the first-line treatment for strep throat, but it may be prescribed in certain cases, such as when there's concern about beta-lactamase producing organisms or in cases of recurrent infections. The typical adult dose is 875 mg/125 mg twice daily or 500 mg/125 mg three times daily for 10 days. For children, dosing is based on weight, usually 45 mg/kg/day divided into two doses. According to the Infectious Diseases Society of America guidelines 1, penicillin V or amoxicillin alone are typically the first-line treatments for strep throat. However, Augmentin may be beneficial in certain circumstances, such as in patients with recurrent infections, as it has been shown to yield high rates of pharyngeal eradication of streptococci 1. It's essential to complete the full course of antibiotics even if symptoms improve before finishing. Common side effects of Augmentin include diarrhea, nausea, and rash. Taking Augmentin with food can help reduce stomach upset. If you develop severe diarrhea, severe rash, or difficulty breathing, contact your healthcare provider immediately as these could indicate serious adverse reactions. The choice of antibiotic should be based on the patient's specific needs and medical history, and it's crucial to follow the recommended treatment guidelines to ensure effective treatment and prevent complications. In general, the treatment of strep throat aims to reduce morbidity, mortality, and improve quality of life by preventing acute rheumatic fever, suppurative complications, and minimizing the risk of transmission to others.

From the FDA Drug Label

Adults and Pediatric Patients Upper Respiratory Tract Infections of the Ear, Nose, and Throat: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),

• Augmentin is a combination of amoxicillin and clavulanic acid, but the provided label is for amoxicillin.
• The label states that amoxicillin is indicated for the treatment of infections due to susceptible Streptococcusspecies, which includes the bacteria that causes strep throat.
• However, Augmentin is not explicitly mentioned in the label, and the question is about Augmentin, not amoxicillin.
• Since the label does not directly address Augmentin, no conclusion can be drawn about its effectiveness in treating strep throat 2.

From the Research

Effectiveness of Augmentin in Treating Strep Throat

• Augmentin, also known as amoxicillin/clavulanate, is an antibiotic used to treat various bacterial infections, including strep throat 3.
• According to a study published in The Pediatric Infectious Disease Journal, amoxicillin/clavulanate had a similar clinical efficacy to penicillin V and clarithromycin in treating group A streptococcal tonsillopharyngitis 3.
• However, the study found that amoxicillin/clavulanate was more effective in eradicating the bacteria than clarithromycin, especially in cases where the bacteria were resistant to clarithromycin 3.
• Another study published in The Cochrane Database of Systematic Reviews found that cephalosporins, macrolides, and carbacephem may be as effective as penicillin in treating group A streptococcal pharyngitis, but the evidence was uncertain due to the low quality of the studies 4.

Comparison with Other Antibiotics

• A study published in Anales de Pediatria compared the effectiveness of a 5- to 7-day antibiotic regimen with a traditional 10-day regimen in treating acute streptococcal pharyngitis and found no significant differences in outcomes 5.
• The study published in The Cochrane Database of Systematic Reviews also found that azithromycin may be as effective as amoxicillin in treating group A streptococcal pharyngitis, but the evidence was uncertain due to the low quality of the study 4.

Recommendations

• The American Family Physician recommends penicillin or amoxicillin as the first-line treatment for strep throat, with cephalosporins or macrolides as alternative options for patients with penicillin allergies 6, 7.
• The choice of antibiotic and duration of treatment should be based on the severity of the infection, patient factors, and local resistance patterns 6, 7.