IV benzylpenicillin 1.2g four times daily if severe. Avoid ampicillin or amoxicillin.
Tonsillitis / Pharyngitis / Sore Throat
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| Indications | Average length of illness 1 week. Consider delayed antibiotic strategy. 75% of infections are viral not bacterial, both may have exudate. If 3 or 4 centor criteria (fever, purulent tonsils, cervical lymphademopathy, no cough) or history of otitis media then antibiotics may be of more benefit. |
| Organism | S.pyogenes, beta-haemolytic Strep |
| Samples | Clinically suspicious of glandular fever, consider laboratory investigation. |
| Treatment | |
| 1st line | Penicillin
V (dose and formulation depends on the age of the patient). |
| Adult: | Penicillin
V 1g twice daily or 500mg four times daily. Minimum of ten days treatment.
Clarithromycin 500mg twice
daily for 5 days in true penicillin allergy only. IV benzylpenicillin 1.2g four times daily if severe. Avoid ampicillin or amoxicillin. |
| For further details on Management of Sore Throat and Indications for Tonsillectomy see SIGN Guideline No 117 | |
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