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Recommended first-line treatment for group A streptococcus pharyngitis
The Rheumatic Fever Prevention Programme recommends the following antibiotics for the treatment of Group A streptococcal pharyngitis in children at high risk of rheumatic fever (Māori and Pacific children and young people living in high risk areas of the North Island):
Table 1: Recommended regimen for oral or intramuscular antibiotics for treatment of GAS pharyngitis
|First line treatment|
|Amoxicillin orally for 10 days||Children < 30 kg: 750 mg once daily
Children ≥ 30 kg: 1000 mg once daily
|Benzathine benzylpenicillin, intramuscular, single dose||Children < 30 kg: 450 mg (600,000 units)
Children ≥ 30 kg: 900 mg (1,200,000 units)
|Alternative for definite or possible anaphylaxis to penicillin or amoxicillin|
|Erythromycin ethyl succinate orally for 10 days||Children and adults: 40 mg/kg/day in 2–3 divided doses|
A rheumatic fever e-learning course is available at LearnOnline. The course is free, and is aimed at primary care nurses, public health nurses and community health workers who work with families whose children are at risk of developing rheumatic fever.
Guidance for administering an intramuscular injection of benzathine benzylpenicillin
This guidance provides a standardised protocol for administering intramuscular penicillin (benzathine benzylpenicillin), with lignocaine added for pain relief, to treat group A streptococcus (GAS) pharyngitis.
When using this guidance, registered health professionals remain responsible for ensuring their practice is up to date and informed by current evidence and individual patient assessment.
Note: 'Lignocaine' is referred to in this guidance. 'Lignocaine' is another name for 'lidocaine'.
Information sheet: Treating a sore throat with a single penicillin injection
You can give this information sheet to people who have agreed to have intramuscular penicillin, with lignocaine added for pain relief, to treat group A streptococcus (GAS) pharyngitis. It explains the injection process and what to expect after the injection is given. It also allows the health professional to record the antibiotic injection time and dose for the patient’s information.
- English: Treating a sore throat with a single penicillin injection (pdf, 98KB)
- Te Reo Māori: Te whakamaimoa i te korokoro mamae mā te weronga rongoā paturopi (pdf,110 KB)
- Samoan: Togafitia o le fa‘a‘i tigā i se tui penisini e tasi (pdf, 97 KB)
- Tongan:Ko hono faito‘o ‘o e mamahi ‘o e monga‘ ‘aki ha huhu penisilini tu‘o taha pē (pdf, 98KB)