Late relapse or Recurrent

- Continuous antibiotic prophylaxis is not recommended.

- Many relapses are viral. Ensure that the throat swab is still positive.

 

Usual Pathogens

Group A Streptococci

 

Empiric Therapy

Dose

Duration
If can take tablets:    
Penicillin VK ≤ 27kg: 300 mg per dose PO 2 or 3 times per day

10 days

  > 27kg: 600 mg per dose PO 2 or 3 times per day  
If suspension required:    
Amoxicillin 50mg/kg PO once daily (or 25mg/kg 2 times per day) (maximum 1000mg per day)

10 days

Penicillin allergy

Empiric Therapy

Dose

Duration

Cephalexin

40mg/kg/d PO div bid 10 days

Penicillin and cephalexin allergy

Empiric Therapy Dose Duration
Clindamycin 20mg/kg/d PO div tid 10 days