• COVID-19
  • Allergies and Infant Formula
  • Pharmacology
  • Telemedicine
  • Drug Pipeline News
  • Influenza
  • Allergy, Immunology, and ENT
  • Autism
  • Cardiology
  • Emergency Medicine
  • Endocrinology
  • Adolescent Medicine
  • Gastroenterology
  • Infectious disease
  • Nutrition
  • Neurology
  • Obstetrics-Gynecology & Women's Health
  • Developmental/Behavioral Disorders
  • Practice Improvement
  • Gynecology
  • Respiratory
  • Dermatology
  • Diabetes
  • Mental Health
  • Oncology
  • Psychiatry
  • Animal Allergies
  • Alcohol Abuse
  • Rheumatoid Arthritis
  • Sexual Health
  • Pain

Recurrent Strep Throat: How Best to Treat

Publication
Article
Consultant for PediatriciansConsultant for Pediatricians Vol 4 No 5
Volume 4
Issue 5

If the infectious agent is penicillin-sensitive and especially if the patient responds well to penicillin VK with each episode, would a longer course of penicillin be a more effective treatment?

 

For patients who have repeated culture-positive episodes of streptococcal pharyngitis, current recommendations include treatment with amoxicillin/clavulanate or clindamycin. If the infectious agent is penicillin-sensitive and especially if the patient responds well to penicillin VK with each episode, would a longer course of penicillin be a more effective treatment?

---- MD

All group A streptococci are highly sensitive to penicillin. Therefore, when treatment failure occurs, it is not because of antibiotic resistance. Recurrent episodes of "strep throat" are often recurrences of viral pharyngitis in a patient who is a chronic pharyngeal carrier of streptococci. Penicillins are relatively poor at eradicating carriage, but clindamycin is effective more than 90% of the time.

Some authors believe that persistent or recurrent streptococcal infections represent a situation in which the presence of a co-pathogen capable of destroying penicillin or amoxicillin, such as Staphylococcus aureus, enables the streptococci to survive. They justify use of a broader-spectrum antibiotic on that basis. However, there is no convincing evidence to support this theory or the use of broader-spectrum agents.

---- Stanford T. Shulman, MD
Professor of Pediatrics
Feinberg School of Medicine
Northwestern University
Chief, Division of Infectious Diseases
Children's Memorial Hospital Chicago

Related Videos
Donna Hallas, PhD, CPNP, PPCNP-BC, PMHS, FAANP, FAAN
Scott Ceresnak, MD
Scott Ceresnak, MD
Importance of maternal influenza vaccination recommendations
Reducing HIV reservoirs in neonates with very early antiretroviral therapy | Deborah Persaud, MD
Samantha Olson, MPH
Deborah Persaud, MD
Ari Brown, MD, FAAP | Pediatrician and CEO of 411 Pediatrics; author, baby411 book series; chief medical advisor, Kabrita USA.
© 2024 MJH Life Sciences

All rights reserved.