What oral antibiotic regimen is appropriate for a 38‑year‑old woman with an acute upper respiratory infection, sore throat, mild tonsillar exudate, CRP 109 mg/L, afebrile, oxygen saturation 99%, and no known drug allergies?

Group A Streptococcal Pharyngitis: Oral Antibiotic Regimen (No Penicillin Allergy)

Antibiotic treatment is recommended for confirmed group A streptococcal (GAS) pharyngitis in adults. [1] For patients without penicillin allergy, penicillin V or amoxicillin are recommended as first-line therapy. [1]

Medication Selection Algorithm

• Narrow-spectrum penicillin therapy
• Penicillin V (oral) for 10 days. [1]
• Amoxicillin (oral) for 10 days. [1]

Appropriate Oral Regimen for a Non-allergic Adult

• Penicillin V 500 mg PO twice daily for 10 days. [1]

Alternative First-Line Oral Regimen

• Amoxicillin 1000 mg PO once daily for 10 days. [1]
• OR amoxicillin 500 mg PO twice daily for 10 days. [2]

Treatment Initiation Thresholds

GAS testing (rapid antigen detection test and/or throat culture) should be performed for patients with sore throat features suggestive of GAS to confirm indication for antibiotics. [1]

Targets or Goals of Therapy

Antibiotic therapy for confirmed GAS pharyngitis should be administered for 10 days to eradicate the organism. [1]