Parents of children suffering from pharyngitis, commonly called "strep throat," may want to ask their pediatrician about the most effective cure. According to the CDC, the antibiotics penicillin and amoxicillin are the best at fighting Streptococcus A, the bacteria that causes strep throat. The American Academy of Pediatrics, the American Heart Association, and the World Health Organization also recommend penicillin for strep throat. However, other courses of treatment are available to children who are allergic to penicillin.
"The most commonly prescribed antibiotic for streptococcal pharyngitis is amoxicillin," says Scott Grant, M.D., MPH, FAAP, general pediatrics and hospital medicine at Detroit Medical Center’s Children's Hospital of Michigan. "Penicillin V is still the treatment of choice, but most pediatricians prescribe amoxicillin due to the convenience of taking the medication two times per day versus three times per day for penicillin V. Amoxicillin also has a much more palatable flavor compared to liquid penicillin."
Both antibiotics treat all strep throat in a 10-day course, adds Dr. Grant, which is important for avoiding one of the dangerous potential complications of untreated strep throat, acute rheumatic fever, an inflammatory disease that can involve the heart, joints, skin, and brain.
For children with a penicillin allergy, Dr. Grant says most pediatricians prescribe a class of antibiotics called macrolides, including familiar antibiotics like azithromycin and erythromycin. "However, these antibiotics are not as effective as penicillin or amoxicillin, so close follow-up with a pediatrician or family doctor is necessary to ensure cure of the infection is achieved," he cautions.
Clindamycin is another consideration for patients with a serious penicillin allergy, if macrolide doesn't work. The CDC also recommends a class of antibiotics called cephalosporins, including cephalexin and cefadroxil. Some older studies—such as a 2004 meta-analysis of 35 studies involving more than 7,000 children—have even suggested cephalosporins may be more effective at treating strep bacteria than penicillin, yet the American Academy of Pediatrics (AAP) still recommends penicillin.
The main reason for the AAP's recommendation is because they know it prevents rheumatic fever.
"The cause of rheumatic fever is strep throat, but if people are treated with the appropriate antibiotics, you can prevent it," says Bob Baltimore, M.D., professor at Yale University School of Medicine and member of the Committee of Infectious Diseases. "We have known that for the eradication of strep in the throat, there are antibiotics that are better than penicillin, but they neither make you better faster, nor prove that they prevent rheumatic fever."
The AAP's guideline on strep throat can be found in the Red Book, which is published every three years by the AAP based on the recommendations of the Committee on Infectious Diseases. The Red Book can be changed at any time if updates need to be made to physicians, Dr. Baltimore says.
Most kids contract strep from other infected kids. The bacteria are transmitted by respiratory secretions on hands, toys, and other objects. The symptoms are white spots on a red throat, fever, difficulty swallowing, and sometimes, swollen glands in the neck.
Parents should call their child's doctor if their little one develops even a mild sore throat and a low-grade fever lasting more than 24 hours. Because of complications that can arise if left untreated, it's essential to call the doctor if you suspect your child may have strep. The doctor will take a throat culture.
If your child does need antibiotics, you can make her recovery smoother by taking advantage of convenient services like Prioritized Pediatric pick-up by CVS at Target. When you get to CVS at Target, just let the pharmacist know your kid’s script is for strep throat—conditions such as cold, cough, and ear infection also qualify—and they’ll fill it quickly. The in-store pharmacy can add flavoring like banana, grape, and watermelon to any liquid med for free. This way, your little one has no excuse not to take her strep throat cure. The best part: By the time you’re done with the rest of your Target shopping, the prescription will be ready to take home.