Adult Outpatients: Respiratory Tract Infections: Pharyngitis

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Doses provided in this table are for patients with normal renal and hepatic function. Click on drug link to go to dosing guidelines.  Some antimicrobials are restricted (ID-R).  Click on link for guidelines on obtaining authorization.

Diagnosis

Common Pathogens

Drug(s) of First Choice

Alternative Drug(s)

Comments

Pharyngitis

 

Viral (EBV, rhinovirus, coronavirus, adenovirus etc)

Group A Streptococcus

(5-20%)

 

Penicillin VK 250 mg PO TID-QID x 10 days

For severe PCN allergy:

Clindamycin 300 mg PO TID x 7-10 days

Most pharyngitis is viral thus antibiotics should not be used.

 

Treatment with PCN prevents rheumatic fever.

 

Treat documented Group A streptococcal infection confirmed by rapid strep. antigen test or culture or if 3 out 4 clinical criteria present.

 

Clinical Criteria: history of fever, tender anterior cervical adenopathy, absence of cough, tonsillar exudates.

 

Penicillin resistance has not been observed.