Strep Pharyngitis Antibiotics

First-line treatments

Amoxicillin

Children: 50 mg per kg per day orally (maximum: 1,000 mg per day)

10 days

$4

Adults with mild to moderate GABHS pharyngitis: 500 mg orally two times per day

Adults with severe GABHS pharyngitis: 875 mg orally two times per day

Penicillin G benzathine

Children < 60 lb (27 kg): 6.0 × 10⁵ units intramuscularly

One dose

Varies

Children ≥ 60 lb and adults: 1.2 × 10⁶ units intramuscularly

Penicillin V

Children with mild to moderate GABHS pharyngitis: 25 mg per kg per day orally, in two divided doses (maximum: 1,000 mg per day)

10 days

$5

Children with severe GABHS pharyngitis: 50 mg per kg per day orally, in two divided doses (maximum: 1,000 mg per day)

Adults: 500 mg orally two times per day

Treatment for patients with type IV hypersensitivity to penicillin

Cephalexin (Keflex)

Children: 25 to 50 mg per kg per day orally, in two divided doses (maximum: 1,000 mg per day)

10 days

$4 ($190)

Adults: 500 mg orally two times per day

Treatments for patients with type I hypersensitivity to penicillin

Azithromycin (Zithromax)

Children: 12 mg per kg per day orally (maximum: 500 mg per day)

5 days

$10 ($148)

Adults: 500 mg orally on day 1, then 250 mg on days 2 through 5

Clarithromycin (Biaxin)

Children: 7.5 mg per kg every 12 hours (maximum: 500 mg per dose)

10 days

$23 ($202)

Adults: 250 mg orally every 12 hours

Clindamycin

Children: 21 mg per kg per day orally, divided every eight hours (maximum: 300 mg per dose)

10 days

$17

Adults: 300 mg orally every eight hours