Pharyngitis / tonsillitis
Consider no antibacterial treatment for 24-48 hours.
Only treat with antibacterials if likely streptococcal.
Preferred
phenoxymethylpenicillin (penicillin V) po see dosing table
Treat for 5 days.
|
Age |
phenoxymethyl penicillin (penicillin V) oral dose |
|
1 month to 11 months |
62.5mg QDS |
|
1 year - 5 years |
125mg QDS |
|
6-11 years |
250mg QDS |
|
12-18 years |
500mg QDS |
If penicillin suspension not tolerated (palatability), use amoxicillin po, see dosing table. Alternatively dosing of 40mg/kg (Max 1g) po BD may be used*
Treat for 5 days.
|
Age |
Amoxicillin oral dose |
|
1 month to 11 months |
125mg TDS |
|
1 year - 4 years |
250mg TDS |
|
5 years and over |
500mg TDS |
*Off-license dosing. Reference: World Health Organisation. Recommendations for management of common childhood 2012 conditions. WHO link accessed 02/23
If rash develops whilst receiving amoxicillin, consider EBV as well as a possible drug rash. Amoxicillin should be stopped. A macrolide could be prescribed as an alternative if streptococcal infection is strongly suspected.
If severe or orals not tolerated: consider benzylpenicillin 50mg/kg (Max 2.4g) iv QDS
Alternative
For penicillin allergy (non-severe and severe)
Under 6 months: clarithromycin po, see dosing table, for 5 days
| Weight | clarithromycin oral dose |
| Under 8kg | 7.5mg/kg BD |
| 8 - 11kg | 62.5mg BD |
| 12 - 19 kg | 125mg BD |
6 months and over: azithromycin 10mg/kg (Max 500mg) po OD for 3 days.