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Experts discourage treatment pending
culture results5-6, but if you do... |
 |
Make sure to stop antibiotics when culture is negative. |
|
Discourage parents from saving antibiotics. |
| If an antibiotic is prescribed: |
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Use a penicillin as treatment for group A strep.7 |
| |
NO group A strep are resistant to penicillin.
Treatment is 90% effective at elimination of
strep, and may be higher in the prevention of acute rheumatic fever (ARF). Carriers are at very low risk for both ARF and spreading infection.7 |
|
Use erythromycin if penicillin allergic. |
References |
| 1. |
Schwartz B, Marcy SM, Phillips WR, Gerber MA, Dowell SF, Pharyngitis-principles of judicious use of antimicrobial agents. Pediatrics 1998;101:171-174 |
| 2. |
Tanz RR, Shulman ST. Diagnosis and treatment of group A streptococcal pharyngitis. Semin Pediatr Infect Dis 1995;6:69-78. |
| 3. |
Poses RM, Cebul RD, Collins M, et al. The accuracy of experienced physicians’ probability estimates for patients with sore throat: implications for decision making. JAMA 1985;254:925-29. |
| 4. |
Denson MR. Viral pharyngitis. Semin Pediatr Infect Dis 1995;6:62-68. |
| 5. |
American Academy of Pediatrics. Group A streptococcal infections. In: Pickering LK, ed. 2000 Red Book: Report of the Committee on infectious Diseases. 25th ed. Elk Grove, IL: American Academy of Pediatrics; 2000:528. |
| 6. |
.Middleton DB, D’ Amico FD, Merenstein JH. Standardized symptomatic treatment versus penicillin as
initial therapy for streptococcal pharyngitis. J Pediatr 1988;113:1089-94. |
| 7. |
Shulman ST, Gerber MA, Tanz RR, Markowitz M. Streptococcal pharyngitis: the case for penicillin therapy. Pediatr Infect Dis J 1994;13:1-7. |
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