How is pediatric pharyngitis initially treated?

Updated: Dec 11, 2018
  • Author: Harold K Simon, MD, MBA; Chief Editor: Russell W Steele, MD  more...
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Answer

For patients with signs of dehydration, administer adequate oral or intravenous (IV) fluids. Remember that pain may limit oral intake, complicating hydration maintenance in the patient. Rarely, small children with pharyngitis who have signs and symptoms of dehydration after refusing to drink may require hospitalization for IV hydration. Usually, even patients who require IV hydration in the emergency department (ED) consume enough oral fluids after their IV fluid bolus to allow home management with close and adequate follow-up care and good instructions for returning if the condition worsens or oral intake is poor.

For patients with group A beta-hemolytic streptococcal (GABHS) pharyngitis, the antibiotic treatment of choice is penicillin. Provided that rapid testing is available, physicians can decide, on the basis of the clinical severity of the pharyngitis, whether to initiate therapy immediately if a rapid test is positive for GABHS or to delay therapy until culture results are obtained. The issue of early versus delayed therapy has several considerations. [9]


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