Penicillins, such as penicillin G benzathine, remain the drugs of choice for treating GAS pharyngitis because of lower cost, a narrower spectrum of activity, and proven safety record. Cephalosporins may be used as first-line therapy if the patient has a history of recurrent pharyngitis infection, recent antibiotic use, or a high penicillin failure rate documented in the community.
Macrolide resistance of GAS varies greatly each year from region to region and patients should receive a macrolide only if a penicillin or cephalosporin is not available. Patients treated with a macrolide for GAS should be followed closely for treatment failure because acute rheumatic fever may follow GAS treatment with macrolides, as seen in rare case reports. Tetracyclines or fluoroquinolones are not typically used to treat GAS pharyngitis.
Learn more about penicillin G benzathine.
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Cite this: Richard H. Sinert. Fast Five Quiz: Pharyngitis (Sore Throat) - Medscape - Dec 14, 2022.