What is the role of penicillin in the treatment of pediatric pharyngitis?

Answer

Penicillin is the typical therapy for group A beta-hemolytic streptococci (GABHS) pharyngitis, in conjunction with prevention of dehydration and supportive care for pain. Many pediatricians prefer amoxicillin oral suspension simply because the taste is much better. Several other antibiotics (eg, macrolides, cephalosporins, amoxicillin-clavulanate) have also been approved to treat GABHS infection. Corticosteroids (eg, oral dexamethasone) have been suggested as an adjunctive therapy; they are not routinely recommended but can be considered.

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Media Gallery

Posterior pharynx with petechiae and exudates in a 12-year-old girl. Both the rapid antigen detection test and throat culture were positive for group A beta-hemolytic streptococci.
Streptococcal pharyngitis. Note the redness and edema of the oropharynx and petechiae, or small red spots, on the soft palate caused by strep throat. Strep throat is caused by group A streptococcus bacteria. These bacteria are spread through direct contact with mucus from the nose or throat of persons who are infected or through contact with infected wounds or sores on the skin.

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Author

Harold K Simon, MD, MBA Professor of Pediatrics and Emergency Medicine, Vice Chair Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta at Egleston

Harold K Simon, MD, MBA is a member of the following medical societies: Academic Pediatric Association, American Academy of Pediatrics, American Pediatric Society, Sigma Xi, The Scientific Research Honor Society

Disclosure: Received grant/research funds from NIH subcontracts for ESETT Sz study. Also MPI on a CDC Concussion grant. All funds go directly to my institution.

Specialty Editor Board

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Chief Editor

Russell W Steele, MD Clinical Professor, Tulane University School of Medicine; Staff Physician, Ochsner Clinic Foundation

Russell W Steele, MD is a member of the following medical societies: American Academy of Pediatrics, American Association of Immunologists, American Pediatric Society, American Society for Microbiology, Infectious Diseases Society of America, Louisiana State Medical Society, Pediatric Infectious Diseases Society, Society for Pediatric Research, Southern Medical Association

Disclosure: Nothing to disclose.

Acknowledgements

Leslie L Barton, MD Professor Emerita of Pediatrics, University of Arizona College of Medicine

Leslie L Barton, MD is a member of the following medical societies: American Academy of Pediatrics, Association of Pediatric Program Directors, Infectious Diseases Society of America, and Pediatric Infectious Diseases Society