By vgreene, 4 October, 2017 Efforts to identify treat GAS carriers not ordinarily justified 9 10 however since it is impossible to distinguish carriers who are experiencing an intercurrent viral infxn from GAS infected individuals a single course of abx is appropriate for pts w acut
By vgreene, 4 October, 2017 A pt w 1 episode of bona fide GAS pharyngitis at close intervals may actually be a chronic pharyngeal GAS carrier who is experiencing repeated viral infxns1
By vgreene, 4 October, 2017 Treat initial repeat acute episode w 1st gen cephalosporin clindamycin azithromycin or clarithromycin 1 3 consider adjunctive tx
By vgreene, 4 October, 2017 Adjunctive tx Consider analgesics antipyretic if high fever mod severe sx 5 but avoid aspirin in children 1 Corticosteroids not recommended8
By vgreene, 4 October, 2017 azithromycin 12 mg kg max 500 mg PO daily x1 day then 6 mg kg max 250 mg PO daily x4 days 1 7 Note AHA6 recommends 12 mg kg PO daily max 500 mg x5 days
By vgreene, 4 October, 2017 clindamycin 7 mg kg PO tid x10 days max 300 mg dose 1 3 Note AHA6 recommends 20 mg kg day divided tid max 1 8 g day
By vgreene, 4 October, 2017 If repeated recurrent episodes consider possibility of chronic carrier state
By vgreene, 4 October, 2017 Do not perform tonsillectomy solely to reduce frequency of GAS pharyngitis1
