Treatment of Streptococcus pseudoporcinus Throat Infection

First-Line Treatment for Non-Allergic Patients

The American Academy of Family Physicians recommends penicillin V as the treatment of choice due to its proven efficacy, narrow spectrum, safety profile, and low cost, with a dosing regimen of 250 mg four times daily or 500 mg twice daily for 10 days in adults, and 250 mg two or three times daily for 10 days in children 1, 2, 3
The American Academy of Family Physicians also recommends amoxicillin as an equally effective and more palatable alternative, particularly for young children, with a dosing regimen of 50 mg/kg once daily or 25 mg/kg twice daily for 10 days 1, 2, 3
The Infectious Diseases Society of America recommends intramuscular benzathine penicillin G when adherence to oral therapy is unlikely, with a dosing regimen of 600,000 units for patients under 60 lbs and 1,200,000 units for patients over 60 lbs as a single injection 1, 2, 3

The American Academy of Allergy, Asthma, and Immunology recommends first-generation cephalosporins as the preferred treatment for patients with non-immediate hypersensitivity reactions, with a dosing regimen of 20 mg/kg per dose twice daily for cephalexin and 30 mg/kg once daily for cefadroxil for 10 days 1, 2, 4
The Infectious Diseases Society of America recommends clindamycin as the preferred alternative for patients with immediate hypersensitivity reactions, with a dosing regimen of 7 mg/kg per dose three times daily for 10 days 2, 4
The American Academy of Family Physicians recommends azithromycin as an acceptable alternative, with a dosing regimen of 12 mg/kg once daily for 5 days 1, 2, 4

The Centers for Disease Control and Prevention recommend that all antibiotics except azithromycin require a full 10-day course to achieve maximal pharyngeal eradication and prevent complications 1, 2, 4

The American Academy of Family Physicians recommends avoiding tetracyclines, sulfonamides, and trimethoprim-sulfamethoxazole as they do not effectively eradicate streptococci from the pharynx 2
The Infectious Diseases Society of America recommends avoiding older fluoroquinolones due to limited activity against streptococci 2
The American Academy of Allergy, Asthma, and Immunology recommends avoiding cephalosporins in patients with immediate/anaphylactic penicillin reactions due to the 10% cross-reactivity risk 2, 4

The American Academy of Family Physicians recommends acetaminophen or NSAIDs for moderate to severe symptoms or high fever, and avoiding aspirin in children due to the risk of Reye syndrome 4

The Infectious Diseases Society of America recommends that chronic carriers generally do not require treatment as they are unlikely to spread infection or develop complications 1, 4
The American Academy of Family Physicians recommends that treatment of asymptomatic household contacts is not routinely recommended unless special circumstances exist 1, 3