Strep Throat

Diagnosis – Should not be made clinically but consistent with either exposure, or palatal petechiae, fever, tender cervical LAD, rash, abdominal pain, winter season, school age child, lack of URI sx.

Confirmatory tests:
- Rapid Strep – Available in ED
- Culture – Gold Standard

Treatment:
PO:
- Amoxillin – 50 mg/kg/day BID X 10 days (max 1 gram BID)
- For patients allergic to penicillin:
- First-generation cephalosporins(Keflex X 5 days)(unless anaphylactic reaction to penicillin)
- If anaphylaxis to Penicillin: Zithromax 10 mg/kg/day X 3 days.

Intramuscular:
- LA Bicillin 600,000 inuts if < 26 lbs
- LA Bicillin 1.2 million units if > 26 1bs