Nelson Textbook of Pediatrics 22nd Edition | Viral vs Group A Streptococcal (GAS) pharyngitis. Clinical features (Centor/McIsaac criteria), diagnosis (RADT, throat culture, PCR), treatment (penicillin/amoxicillin first-line, macrolides for allergy), complications (acute rheumatic fever, post-streptococcal glomerulonephritis, peritonsillar abscess, Lemierre syndrome), and chronic GAS carrier management.
🌐 paeds.online — Pakistan's Pediatric Platform| Situation | Antibiotic | Duration |
|---|---|---|
| GAS pharyngitis (non-allergic) | Penicillin V (or amoxicillin once daily) | 10 days |
| GAS pharyngitis (penicillin allergy - non-type I) | Cephalexin (1st gen cephalosporin) | 10 days |
| GAS pharyngitis (type I hypersensitivity) | Clindamycin or azithromycin (5 days) | 10 days or 5 days |
| Chronic GAS carrier (symptomatic) | Clindamycin 20 mg/kg/day ×10d or amoxicillin-clavulanate | 10 days |
| Rheumatic fever prophylaxis | Benzathine penicillin G IM q4weeks | Long-term |