Group A strep pharyngitis

As you all know, penicillin V in oral suspension has been off the market for some time. Since that time we have largely been prescribing amoxicillin for patients with suspected GAS pharyngitis, for them to fill if their culture ends up being positive.

It seems the new check form prescriptions are at the printers, and will be stocked in the ED in short order.

In the meanwhile, I wanted everyone to know what we should be prescribing to these patients, both for simplicity's sake, and to assist in standardizing our practice for this common problem.

For penicillin non-allergic patients give:

• <27kg, amoxicillin suspension or chewables, 250 mg po BID x 10 days
• >27kg, amoxicillin suspension, chewables, or tabs, 500 mg po BID x 10 days

For penicillin allergic patients give:

• azithromycin suspension or tabs, 12 mg/kg/day, in a single daily dose x 5 days (max. 500 mg/day)

Thank you to Dr. Ilana Greenstone for her work on this initiative, and for providing the information included within.