Tonsillitis and Pharyngitis Empiric Therapy 

Updated: Nov 23, 2015
  • Author: Udayan K Shah, MD, FACS, FAAP; Chief Editor: Michael Stuart Bronze, MD  more...
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Empiric Therapy Regimens

Empiric therapeutic regimens for tonsillitis and pharyngitis are outlined below, including adult and pediatric dosages for both penicillin-allergic and non-penicillin-allergic patients. [1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13]

If results are not available for rapid strep test, culture, or Monospot

Adult dosage:

Pediatric dosage:

  • Penicillin V 25-50 mg/kg/day divided q6h for 10d or
  • Benzathine penicillin G 25,000 U/kg IM once (maximum 1.2 million U) or
  • Amoxicillin 50 mg/kg/day PO in 2 or 3 divided doses for 10d or
  • Amoxicillin-clavulanate 500-875 mg PO q12h for 10d
  • Cefdinir 14 mg/kg PO once daily for 10d or
  • Cefuroxime axetil 10 mg/kg PO BID for 4-10d

Adult dosage if penicillin allergic:

Pediatric dosage if penicillin allergic:

  • Azithromycin 12 mg/kg PO once daily for 5d or
  • Clarithromycin 250 mg PO q12h for 10d or
  • Erythromycin succinate 20 mg/kg PO BID for 10d or
  • Clindamycin 7 mg/kg/day PO in 3 divided doses (maximum 1.8 g/d) for 10d