Spectrum: Local Antimicrobial Stewardship, for IWK Health Centre

Streptococcal pharyngitis / tonsillitis

Most likely pathogen

Streptococcus pyogenes (Group A Strep)

Duration of therapy

10 days

Suggested regimen

For older children and adolescents that can use tablets: (Penicillin VK suspension unavailable)

Penicillin VK
less than or equal to 27 kg:

300 mg/dose PO BID
greater than 27 kg: 600 mg/dose PO BID

OR

Amoxicillin 50 mg/kg/24h PO divided q12-24h
Maximum: 1 gram/24h

OR

Penicillin G 0.025 million units/kg/dose IV q6h
Maximum: 24 million units/24h

Penicillin allergy

Clarithromycin 7.5 mg/kg/dose PO BID
Maximum: 1 gram/24h

OR

Cefazolin 16-33 mg/kg/dose IV q8h
Maximum: 6 grams/24h