Treatment of Acute Tonsillitis with β-Hemolytic Streptococcal Infection (Group A, C, or G) in Patients Aged 15 and Older
Antibiotic treatment of acute tonsillitis is warranted in a well-defined subset of patients: those aged 15 years and older with a McIsaac score of at least 3, a highly suspected or confirmed β-hemolytic streptococcal infection (group A, C, or G), and no penicillin allergy or incompatibility.
Antibiotic therapy is indicated only when a β-hemolytic streptococcal infection of group A, C, or G is highly suspected or confirmed. For patients with sore throat in times and regions without epidemic streptococcal occurrence and a low regional incidence of streptococcal sequelae, a McIsaac score of at least 3 guides the decision to prescribe oral antibiotic therapy. This protocol specifically addresses patients aged 15 years and older.
The recommended first-line approach for this patient group involves an oral antibiotic in the penicillin class — the complete regimen, including the specific agent and schedule, is detailed in the full protocol.
DOI: 10.1007/s00405-015-3872-6
- 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 15 years and older:
- Penicillin V (3 × 0.8–1.0 Mio IU/day for 7 days)
- With adequate therapy, most of the patients, especially adolescents and adults, are free of symptoms within 48 h.