Treatment of Acute Tonsillitis in Children Aged 3–14 with Suspected β-Hemolytic Streptococcal Infection (Group A, C, or G) and McIsaac Score ≥ 3
Clinical Scenario
This protocol addresses children aged 3–14 years presenting with acute tonsillitis in whom β-hemolytic streptococcal infection (Group A, C, or G) is highly suspected or confirmed, with a McIsaac score of at least 3 and no penicillin allergy or incompatibility.
Conditions for This Approach
- Highly suspected or proven β-hemolytic streptococcal infection — Group A, C, or G
- McIsaac score of at least 3
- Age 3–14 years
- No penicillin allergy or incompatibility
Treatment Approach
For children in this age group and clinical scenario, oral penicillin-based antibiotic therapy is recommended — the full protocol specifies the agents, dosing schedule, and course duration.
Goal: symptom-free within 48 hours
References
- Antibiotic therapy is indicated only in case of a highly suspected or proven b-hemolytic streptococci infection (of group A, C, or G).
- For patients with sore throat in times and regions without epidemic occurrence of b-hemolytic streptococcal infection, a low regional incidence of streptococcal sequelae and a McIsaac-Score of at least 3, oral medication is recommended as follows
- Age 3–14 years:
- Penicillin V (100,000 IU/kg/day in three doses for 7 days), or Phenoxymethylpenicillin–Benzathin (50,000 IU/kg/day in two doses for 7 days)
- With adequate therapy, most of the patients, especially adolescents and adults, are free of symptoms within 48 h.
DOI: 10.1007/s00405-015-3872-6
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