GAS pharyngitis is typically characterized by fever, tender cervical lymphadenopathy, with pharyngeal exudate. Patients may have a scarletiniform rash. Typically there is no cough, conjuctivitis or congestion which are supportive of a viral etiology. Culture of pharynx should be done to confirm diagnosis.
Penicillin V given TID is the drug of choice for GAS pharyngitis and should be used preferentially for older children and adolescents.
However in children where suspension is required, amoxicillin (dose of 50 mg/kg/day) divided BID or TID for 10 days has also been shown to be as effective as TID penicillin.
Droplet / Contact Precautions
Until 24 hours of appropriate antimicrobial therapy
Streptococcus pyogenes (GAS)
Penicillin tablet PO
CeFURoxime axetil PO
See Antibiotic Allergies Section