Acute Sore Throat
Avoid antibiotics as 82% resolve in 7 days without, and pain only reduced by 16 hours. Use FeverPAIN Score: Fever in last 24h, Purulence, Attend rapidly under 3d, severely Inflamed tonsils, No cough or coryza). Score 0-1: 13-18% streptococci, use NO antibiotic strategy; 2-3: 34-40% streptococci, use 3 day back-up antibiotic; >4: 62-65% streptococci, use immediate antibiotic if severe, or 48hr short back-up prescription.
Always share self-care advice & safety net.
Antibiotics to prevent Quinsy NNT >4000.
Antibiotics to prevent Otitis media NNT 200.
10d penicillin lower relapse vs 5d in <18yrs.
500mg QDS or 1G BD (QDS when severe)
1 to 11 months: 62.5mg QDS or 125mg BD
1 to 5 years: 125mg QDS or 250mg BD
6 to 11 years: 250mg QDS or 500mg BD
12 to 17 years: 500mg QDS or 1000mg BD
Penicillin Allergy: Clarithromycin
1 month to 11 years:
Under 8 kg - 7.5mg/kg BD
8 to 11 kg - 62.5mg BD
12 to 19 kg: 125mg BD
20 to 29 kg - 187.5mg BD
30 to 40 kg - 250mg BD
12 to 17 years: 250mg to 500mg BD
Penicillin Allergy in Pregnancy: Erythromycin