PHARYNX / NECK - Tonsillitis/Pharyngitis by Pathogen (Group A Streptococcus) NOTE: Non- A/B Strep typically does not need treatment for mild adult cases.
Penicillin V Potassium (Pen Vee K^®) Generics Available Pregnancy: B; Lactation: Unk Tabs: 250 mg, 500 mg Oral Susp: 125 mg/5 mL, 250 mg/5 mL	Children <12 years: 25-50 mg/kg/day (max 2 g/day) in divided doses every 6 hours for a full 10 days. 125 mg/5 mL @ 25 mg/kg/day 10 kg (22 lb) = ½ tsp (2.5 mL) Q6H 15 kg (33 lb) = ¾ tsp Q6H 20 kg (44 lb) = 1 tsp (5 mL) Q6H >20 kg (44 lb) = Use adult dose. 250 mg/5 mL @ 50 mg/kg/day 10 kg (22 lb) = ½ tsp (2.5 mL) Q6H 15 kg (33 lb) = ¾ tsp Q6H 20 kg (44 lb) = 1 tsp (5 mL) Q6H >20 kg (44 lb) = Use adult dose. Adult: 250 mg PO four times daily or 500 mg PO two or three times daily for 10 days.			Food: Take 1 hour before or 2 hours after meals. May take with food if GI upset occurs. Important side effects: Nausea, rash.
Penicillin G benzathine - IM may be useful if compliance is questionable. (Bicillin L-A^®, Permapen^®) Pregnancy: B; Lactation: Unk Inject IM only: 300,000 U/mL, 600,000 U/mL	Children <60 lb: 600,000 U IM 1 dose. >60 lb: Use adult dose. Adult: 1.2 mU IM × 1 dose.			Recommended if patient compliance is a concern. Important side effects: Pain at injection site. Use with caution if history of seizures.
Amoxicillin (Amoxil^®) Generics available Pregnancy: B; Lactation: Safe Caps: 250 mg, 500 mg Tabs: 500 mg, 875 mg Chew tab: 125 mg, 200 mg, 250 mg, 400 mg Oral Susp: 125 mg/5 mL, 250 mg/5 mL, 400 mg/5 mL Oral drops: 50 mg/mL	Children: 45-90 mg/kg/day (max 1500 mg/day) in divided doses three times daily for 10-14 days. 250 mg/5 mL at 90 mg/kg/day 8 kg (18 lb) = 1 tsp (5 mL) Q8H 17 kg (37 lb) = 2 tsp (10 mL) Q8H >17 kg = Use adult dose. Adult: 500 mg PO three times daily for 10-14 days.			Food: May take with or without meals. Important side effects: Diarrhea and nausea. May cause nonallergic maculopapular rash. Reduce dose if renal impairment (CrCl <30 mL/min). May be useful in children who require oral suspension due to better palatability vs. penicillin VK suspension. However, penicillin VK remains the drug of choice.
Amoxicillin/clavulanate (Augmentin^®) Pregnancy: B; Lactation: Unk Q12H Formulations: Tabs: 500 mg/125 mg, 875 mg/125 mg Chewable Tabs: 200 mg/28.5 mg, 400 mg/57 mg Oral Susp: 200 mg/28.5 mg/5 mL, 400 mg/57 mg/5 mL, 600 mg/42.9 mg/5 mL		Children: 45 mg amoxicillin component/kg/day (max 1600 mg/day) every 12 hours for 10-14 days. Q12H using 200 mg/5 mL susp @ 45 mg/kg/day 9 kg (20 lb) = 1 tsp (5 mL) Q12H 13 kg (29 lb) = 1½ tsp (7.5 mL) Q12H 18 kg (40 lb) = 2 tsp (10 mL) Q12H Q12H using 400 mg/5 mL susp @ 45 mg/kg/day 18 kg (40 lb) = 1 tsp (5 mL) Q12H 27 kg (59 lb) = 1½ tsp (7.5 mL) Q12H 35 kg (77 lb) = 2 tsp (10 mL) Q12H >40 kg = Use adult dose (max 875 mg Q12H). Adult: 500-875 mg twice daily for 10-14 days. Note: Q12H dosing may improve compliance compared to Q8H dosing.		Food: Take with food to reduce diarrhea. Important side effects: Diarrhea (common), nausea, rash. Reduce dose if renal impairment (CrCl <30 mL/min).
Azithromycin (Zithromax^®) Pregnancy: B; Lactation: Unk Tabs: 250 mg and Z-Pak (500 mg × 1 day, then 250 mg daily × 4) Oral Susp: 100 mg/5 mL, 200 mg/5 mL		Children ≥2 years: 12 mg/kg/day (max 500 mg/day) once daily for 5 days. 100 mg/5 mL 8-9 kg (20 lb) = 1 tsp (5 mL) Q24H 200 mg/5 mL 18 kg (40 lb) = 1 tsp (5 mL) Q24H 25 kg (55 lb) = 1½ tsp (7.5 mL) Q24H 33 kg (73 lb) = 2 tsp (10 mL) Q24H 40 kg (88 lb) = 2½ tsp (12.5 mL) Q24H ≥40 kg (88 lb) = 500 mg Q24H Adolescent ≥16 years and Adult: Dispense one Z-Pak.		Food: Oral suspension should be taken 1 hour before or 2 hours after food. Tablets may be taken without regard to food. Important side effects: Nausea, diarrhea, elevated LFTs.
Cefpodoxime (Vantin^®) Pregnancy: B; Lactation: Unk Tabs: 100 mg, 200 mg Oral Susp: 50 mg/5 mL, 100 mg/5 mL		Children >5 months to 12 years: 10 mg/kg (max 200 mg/day) twice daily for 5-10 days. 50 mg/5 mL @ 10 mg/kg/day 10 kg (22 lb) = 1 tsp (5 mL) Q12H 15 kg (33 lb) = 1½ tsp (7.5 mL) Q12H 100 mg/5 mL @10 mg/kg/day 15 kg (33 lb) = ¾ tsp Q12H ≥ 20 kg (44 lb) = 1 tsp (5 mL) Q12H Children ≥13 years to Adult: 100-400 mg PO twice daily for 4-10 days.		Food: Take tablet with food. Suspension may be taken without regard to food. Important side effects: Diarrhea. Reduce dose if renal impairment (CrCl <30 mL/min).
Cefuroxime axetil (Ceftin^®) Pregnancy: B; Lactation: Unsafe Tabs: 125 mg, 250 mg, 500 mg Oral Susp: 125 mg/5 mL, 250 mg/5 mL		Children ≥3 months to 12 years: 20 mg/kg/day (max 500 mg/day) in divided doses twice daily for 10 days. 125 mg/5 mL @ 20 mg/kg/day 6 kg (13 lb) = ½ tsp Q12H 12 kg (26 lb) = 1 tsp (5 mL) Q12H 18 kg (40 lb) = 1½ tsp Q12H 24 kg (53 lb) = 2 tsp (10 mL) Q12H Children ≥13 years or Adult: 250 mg PO twice daily for 10 days.		Food: Take suspension with food. Tablets may be taken without regard to food. Important side effects: Nausea, vomiting, diarrhea. Reduce dose if renal impairment (CrCl <30 mL/min).
Cephalexin (Keflex^®) Generics available Pregnancy: B; Lactation: Unk Tabs: 250 mg, 500 mg, 1 g Caps: 250 mg, 500 mg Oral Susp: 125 mg/5 mL, 250 mg/5 mL		Children: 25-50 mg/kg/day (max 4 g/day) in divided doses two to four times daily for 10 days. 125 mg/5 mL @ 25 mg/kg/day (double for 50 mg/kg) 10 kg (22 lb) = ½ tsp (2.5 mL) Q6H 15 kg (33 lb) = ¾ tsp Q6H 20 kg (44 lb) = 1 tsp (5 mL) Q6H 250 mg/5 mL @ 25 mg/kg/day (double for 50 mg/kg) 20 kg (44 lb) = ½ tsp (2.5 mL) Q6H 40 kg (88 lb) = 1 tsp (5 mL) Q6H >40 kg = Use adult dose. Adult: 500 mg PO four times daily for 10 days.		Food: Take 1 hour before or 2 hours after meals. May take with food if GI upset occurs. Important side effects: GI upset, diarrhea. Reduce dose if renal impairment (CrCl <40 mL/min).
Clarithromycin* (Biaxin, Biaxin XL^®) Pregnancy: C; Lactation: Unk Tabs: 250 mg, 500 mg Extended Release Tab (XL): 500 mg Oral Susp: 125 mg/5 mL, 250 mg/5 mL		Children ≥6 months: 15 mg/kg/day (max 1 g/day) in divided doses twice daily for 10-14 days. 125 mg/5 mL @15 mg/kg/day 9 kg (20 lb) = ½ tsp (2.5 mL) Q12H 17 kg (37 lb) = 1 tsp (5 mL) Q12H 250 mg/5 mL @ 15 mg/kg/day 17 kg (37 lb) = ½ tsp (2.5 mL) Q12H 25 kg (55 lb) = ¾ tsp Q12H 33 kg (73 lb) = 1 tsp (5 mL) Q12H Adult: 500 mg PO twice daily or 1 g XL once daily for 10 days.		Food: Extended release tablet with food. Others without regard to food. Important side effects: Nausea, drug interactions.
Clindamycin (Cleocin^®) Generics available Pregnancy: B; Lactation: Unk Cleocin Caps: 75 mg, 150 mg, 300 mg Oral Solution: 75 mg/5 mL -		Children: 20-25 mg/kg/day (max 1.8 g/day) in divided doses three time daily for 10 days. 75 mg/5 mL @ 20 mg/kg/day divided Q8H 6 kg (13 lb) = ½ tsp (2.5 mL) Q8H 11 kg (24 lb) = 1 tsp (5 mL) Q8H 22 kg (48 lb) = 2 tsp (10 mL) Q8H 30 kg (66 lb) = 3 tsp (15 mL) Q8H 40 kg (88 lb) = 300 mg Q8H >40 kg = Use adult dose. Adult: Mild to moderate: 150-300 mg PO four times daily for 10-14 days. Severe: 450 mg PO four times daily for 10-14 days.	Food: May take with or without meals. Take with full glass of water to prevent esophagitis. Important side effects: Diarrhea, may be severe. Nausea. May cause severe colitis. Encourage patient to report severe, persistent, or bloody diarrhea.