- a 561-patient trial found that a seven-day course of penicillin is better at resolving symptoms of a streptococcal sore throat than a three-day course. Symptoms resolved significantly quicker - by half to one day
- the use of penicillin caused an accelerated resolution of symptoms by 2.5 days in patients with group A streptococcal sore throat. In those patients with non-group A streptococcal sore throat there was an accelerated resolution of symptoms by 1.5 days
- the prolonged (7-day) penicillin treatment appeared to be protective against the risk of abscess
NICE have suggested in management of sore throat (2):
Antibiotics for adults aged 18 years and over (a,b,c)
- first choice
- Phenoxymethylpenicillin 500 mg four times a day or 1,000 mg twice a day for 5 to 10 days
- alternative first choices for penicillin allergy or intolerance
- Clarithromycin 250 mg to 500 mg twice a day for 5 days
- Erythromycin 250 mg to 500 mg four times a day or 500 mg to 1,000 mg twice a day for 5 days
a. see BNF for appropriate use and dosing in specific populations, for example, hepatic impairment, renal impairment, pregnancy and breastfeeding.
b. doses given are by mouth using immediate-release medicines, unless otherwise stated.
c. erythromycin is preferred in women who are pregnant.
Reference:
- BMJ. 2000;320(7228):150-4
- NICE (January 2018).Sore throat (acute): antimicrobial prescribing