Will Group G streptococcal (GGS) pharyngitis be treated with Zithromax (azithromycin)?

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From the Guidelines

Group G streptococcal throat infection can be treated with a Z-Pak (azithromycin), as it is a recommended alternative for those with penicillin allergies or when compliance might be an issue due to its shorter course. The typical Z-Pak regimen involves taking 500mg on the first day, followed by 250mg daily for the next four days, completing a 5-day course 1. While penicillin is often the first-line treatment for streptococcal infections, azithromycin is a good alternative, as supported by the American Heart Association's guidelines for the prevention of rheumatic fever and diagnosis and treatment of acute streptococcal pharyngitis 1. Group G strep is less common than Group A strep but can cause similar symptoms and complications if left untreated. Azithromycin works by inhibiting bacterial protein synthesis, effectively stopping the bacteria from growing and multiplying. It's essential to complete the entire course of antibiotics even if symptoms improve before finishing the medication. If symptoms persist after completing the Z-Pak, follow up with your healthcare provider as a different antibiotic might be needed or further evaluation may be necessary.

Some key points to consider when treating Group G streptococcal throat infection with azithromycin include:

  • The dosage and duration of treatment, as specified in the guidelines 1
  • The importance of completing the full course of antibiotics to ensure effective treatment and prevent complications
  • The potential for azithromycin to be used as an alternative to penicillin in patients with allergies or compliance issues
  • The need for further evaluation and potential alternative treatment if symptoms persist after completing the Z-Pak.

It's also worth noting that the Infectious Diseases Society of America recommends azithromycin as a treatment option for GAS pharyngitis in penicillin-allergic individuals, with a duration of 5 days 1. However, the most recent and highest quality study, as per the guidelines from the American Heart Association 1, supports the use of azithromycin for the treatment of streptococcal pharyngitis, including Group G strep.

From the Research

Strep G in Throat Treatment

  • The provided studies do not specifically mention "strep G" but rather Group A beta-hemolytic streptococcal (GABHS) pharyngitis, which is a common cause of sore throats.
  • According to the studies 2, 3, 4, first-line treatment for GABHS pharyngitis includes a 10-day course of penicillin or amoxicillin.
  • For patients allergic to penicillin, first-generation cephalosporins, clindamycin, or macrolide antibiotics can be used as alternatives 2, 3, 4.
  • Azithromycin, a type of macrolide antibiotic, is sometimes used to treat streptococcal pharyngitis, but there is significant resistance to it in some parts of the United States 4.
  • A "Z-pak" is a common name for a 5-day course of azithromycin, but it is not typically the first-line treatment for streptococcal pharyngitis due to concerns about resistance and efficacy 5, 4.

Antibiotic Treatment Options

  • Penicillin and amoxicillin are the preferred antibiotics for treating GABHS pharyngitis 2, 3, 4, 6.
  • Cephalosporins may be used as an alternative for patients with non-anaphylactic allergies to penicillin 2, 3, 4.
  • Macrolides, such as azithromycin, may be used in certain cases, but their effectiveness and resistance patterns should be considered 5, 4.
  • The choice of antibiotic should be based on the patient's medical history, allergy status, and local resistance patterns 4.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Common Questions About Streptococcal Pharyngitis.

American family physician, 2016

Research

Diagnosis and treatment of streptococcal pharyngitis.

American family physician, 2009

Research

Streptococcal Pharyngitis: Rapid Evidence Review.

American family physician, 2024

Research

Different antibiotic treatments for group A streptococcal pharyngitis.

The Cochrane database of systematic reviews, 2021

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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