Treatment of Moderate Growth Beta-Hemolytic Streptococcus Group C

First-Line Treatment Options

• The American Academy of Family Physicians recommends oral penicillin V for 10 days, with dosages of 250 mg two or three times daily for children, and 250 mg four times daily or 500 mg twice daily for adolescents and adults 1, 2
• The American Academy of Family Physicians also recommends intramuscular benzathine penicillin G as a single dose, with 600,000 units for patients under 60 lb (27 kg) and 1,200,000 units for patients over 60 lb 1, 2

Alternative Treatment for Penicillin-Allergic Patients

• For non-anaphylactic penicillin allergy, the American Academy of Family Physicians recommends cephalexin at 20 mg/kg per dose twice daily (maximum 500 mg per dose) for 10 days 1, 3
• For patients with immediate hypersensitivity to penicillin, the American Academy of Family Physicians recommends azithromycin at 12 mg/kg once daily (maximum 500 mg) for 5 days 1, 3

Clinical Considerations

• Treatment should continue for a full 10 days to ensure complete eradication of the organism, even if symptoms resolve earlier, as recommended by the Infectious Diseases Society of America 2

Potential Pitfalls and Caveats

• Follow-up testing after treatment is not routinely recommended unless symptoms persist, according to the American Academy of Family Physicians 1
• For recurrent infections, the Infectious Diseases Society of America recommends considering clindamycin or amoxicillin/clavulanate as they have shown higher rates of pharyngeal eradication 2, 4