Convenient schedules and short course treatment of acute streptococcal pharyngitis.

A number of options exist for reducing the frequency of antibiotic dosing and shortening the course of treatment of GAS pharyngitis. All oral agents are more costly than oral penicillin and have a broader spectrum of antimicrobial activity. These issues must be weighed against the convenience of these treatment regimens. At this time penicillin remains the drug of choice for acute streptococcal pharyngitis. Oral penicillin V can be given twice daily for 10 days. Intramuscular benzathine penicillin is inexpensive and obviates any concerns about compliance. For penicillin-allergic patients, twice daily erythromycin for 10 days is preferred but azithromycin once a day for 5 days is a reasonable (but expensive) alternative.