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, 14, 15]
If results are not available for rapid strep test, culture, or Monospot
Adult dosage:
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Penicillin V 500 mg PO BID for 10d or 250 mg PO QID for 10d or
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Benzathine penicillin G 1.2 million U IM once or
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Amoxicillin 500-875 mg PO q12h or 250-500 mg PO q8h for 10d or
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Cefdinir 600 mg PO once daily for 10d or 300 mg PO q12h for 5-10d or
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Cefuroxime axetil 250 mg PO once daily for 4d
Pediatric dosage:
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Penicillin V 25-50 mg/kg/day divided q6h for 10d or
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Benzathine penicillin G 25,000 U/kg IM once (maximum 1.2 million U) or
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Amoxicillin 50 mg/kg/day PO in 2 or 3 divided doses for 10d or
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Amoxicillin-clavulanate 500-875 mg PO q12h for 10d
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Cefdinir 14 mg/kg PO once daily for 10d or
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Cefuroxime axetil 10 mg/kg PO BID for 4-10d
Adult dosage if penicillin allergic:
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Azithromycin 500 mg PO daily for 5d or
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Clarithromycin 250 mg PO q12h for 10d or
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Erythromycin base 500 mg PO QID for 10d or
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Clindamycin 7 mg/kg/day in 3 divided doses (maximum 1.8 g/d) for 10d
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Levofloxacin 500 mg PO once daily for 7d
Pediatric dosage if penicillin allergic:
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Azithromycin 12 mg/kg PO once daily for 5d or
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Clarithromycin 250 mg PO q12h for 10d or
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Erythromycin succinate 20 mg/kg PO BID for 10d or
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Clindamycin 7 mg/kg/day PO in 3 divided doses (maximum 1.8 g/d) for 10d
