Amoxicillin Dosing for Strep Throat

Dosing Recommendations

• The Infectious Diseases Society of America recommends amoxicillin 50 mg/kg once daily (maximum 1000 mg) or alternatively 25 mg/kg twice daily (maximum 500 mg per dose) for 10 days for strep throat, with a "strong, high" recommendation 1, 2
• For adults, the standard dose is 500 mg twice daily for 10 days, equivalent to the weight-based pediatric dosing when scaled appropriately 1, 2

Critical Treatment Principles

• The Infectious Diseases Society of America recommends completing the full 10-day course of amoxicillin regardless of symptom improvement to prevent acute rheumatic fever, with a "strong, high" recommendation 1, 2
• Patients are no longer contagious after 24 hours of appropriate antibiotic therapy, but treatment must continue for the full 10 days to prevent complications 1, 3

Alternative Regimens

• For patients with a documented penicillin allergy, alternative regimens include cephalexin 20 mg/kg/dose twice daily (maximum 500 mg/dose) for 10 days, clindamycin 7 mg/kg/dose three times daily (maximum 300 mg/dose) for 10 days, azithromycin 12 mg/kg once daily (maximum 500 mg) for 5 days, and clarithromycin 7.5 mg/kg/dose twice daily (maximum 250 mg/dose) for 10 days 1, 2

Medication Administration

• Plain amoxicillin is first-line for uncomplicated streptococcal pharyngitis, and amoxicillin-clavulanate is reserved for recurrent cases or suspected resistance 1, 2, 3