Title Acute pharyngitis.pdf ✅

Version: 11 June 2024 National Antimicrobial Guideline, 4th Edition (2024) Clinical Pathways for Primary Care: Acute Pharyngitis Suspected acute tonsillo-pharyngitis e.g. sore throat, painful swallowing Strep score Symptoms or signs Points Absence of cough +1 Temperature >380c +1 Tender/swollen anterior cervical lymph nodes +1 Tonsillar exudates or swelling +1 Age (years): 3 to 14 15 to 44 ≥45 +1 0 -1 Total score < 3 Total score ≥ 3 Symptomatic treatment: e.g. anti-pyretic, analgesic, hydration • Symptomatic treatment • Anti-microbial therapy Recommended dosage (adults) Antibiotics Dosing Duration* Remarks Phenoxymethylpenicillin (Pen V) 500mg PO q6h OR 1gm PO q12h 5-10 days Preferred Amoxicillin 500mg PO q8h 5-10 days Preferred Erythromycin Ethylsuccinate 800mg PO q12h 5-10 days Alternative * Consider 10 days in settings with a high prevalence of rheumatic fever or in patients with a history of rheumatic fever or rheumatic heart disease and who are aged between 3 and 21 years. 1. The WHO AWaRe (Access, Watch, Reserve) antibiotic book 2022. 2. Sore Throat (Acute): Antimicrobial Prescribing. NICE Guideline February 2023. Recommended dosage (children) Antibiotics Dosing Duration Remarks Phenoxymethylpenicillin (Pen V) 25-50mg/kg/day PO q6h (max 2gm/day) 10 days Preferred Amoxicillin 50mg/kg/day PO q12-24h (max 1gm/day) 10 days Preferred Cephalexin 25-50mg/kg/day PO q12h (max 2gm/day) 10 days Alternative Erythromycin Ethylsuccinate 40-50mg/kg/day PO q12h (max 4gm/day) 10 days Alternative 1. The Sanford Guide to Antimicrobial Therapy 2022. 2. American Academy of Paediatrics Committee on Infectious Diseases. Red Book: Report of the Committee on Infectious Diseases 2018.