| Pharngitis / Sore Throat / Tonsillitis Antibiotic Treatment Table |
|
Consider no antibiotic or delayed antibiotic strategy
Use FEVERPAIN Score to identify those most likely to benefit from antibiotics.
Score 0-1: Do not offer antibiotic
Score 2-3: Offer delayed antibiotic
Score 4-5: Offer immediate antibiotic prescription
|
| If antibiotics deemed clinically indicated: |
| Drug |
Dose |
Duration |
Notes |
| Adults: 1st choice options |
|
Phenoxymethylpenicillin
|
666mg every 6 hours
(Calvepen®)
OR 500mg every 6 hours
(Kopen®)
|
5 Days
|
Avoid in penicillin allergy.
Depending on clinical response, duration can be extended to 10 days in total.
If scarlet fever is suspected it is advisable to treat for 10 days duration.
To optimise absorption, take on empty stomach
|
| Adults: 2nd choice options |
|
Amoxicillin
|
500mg every 8 hours
|
5 days
|
Avoid in penicillin allergy.
Depending on clinical response, duration can be extended to 10 days in total.
If scarlet fever is suspected it is advisable to treat for 10 days duration.
|
|
Cefalexin
|
500mg every 6 hours
|
5 Days
|
Depending on clinical response, duration can be extended to 10 days in total.
If scarlet fever is suspected it is advisable to treat for 10 days duration.
Cephalosporins should not be used in severe penicillin allergy.
|
|
Clarithromycin
|
500mg every 12 hours
|
5 Days
|
Depending on clinical response, duration can be extended to 10 days in total.
If scarlet fever is suspected it is advisable to treat for 10 days duration.
Macrolides should be used with caution in pregnancy. Clarithromycin suitable only in 2nd and 3rd trimester in pregnancy.
Alternative macrolide for all trimesters of pregnancy: Azithromycin 500mg stat then 250mg every 24 hours from Day 2 to Day 5.
|
| Children: 1st choice options |
|
Phenoxymethylpenicillin suspension
|
See Phenoxymethylpenicillin dosing for children
|
5 Days
|
Avoid in penicillin allergy.
Depending on clinical response, duration can be extended to 10 days in total.
If scarlet fever is suspected it is advisable to treat for 10 days duration.
To optimise absorption, take on empty stomach.
|
| Children: 2nd choice options |
|
Amoxicillin suspension
|
See Amoxicillin dosing for children
|
5 Days
|
Avoid in penicillin allergy.
Depending on clinical response, duration can be extended to 10 days in total.
If scarlet fever is suspected it is advisable to treat for 10 days duration.
|
|
Cefalexin suspension
|
See Cefalexin dosing for children
|
5 Days
|
Depending on clinical response, duration can be extended to 10 days in total.
If scarlet fever is suspected it is advisable to treat for 10 days duration.
Cephalosporins should not be used in severe penicillin allergy.
|
|
Clarithromycin suspension
|
See Clarithromycin dosing for children
|
5 days
|
Depending on clinical response, duration can be extended to 10 days in total.
If scarlet fever is suspected it is advisable to treat for 10 days duration.
|
