Acute Tonsillo-Pharyngitis Protocol

Strep score calculator and age-stratified antimicrobial selection.

📊 Interactive Strep Score Calculator

Calculate clinical probability to differentiate viral infections from Group A Beta-Hemolytic Streptococcus (GABHS).

Clinical Features

Absence of cough (+1) Temperature > 38°C (+1) Tender / swollen anterior cervical lymph nodes (+1) Tonsillar exudates or swelling (+1)

Patient Age

Current Management Strategy:

Provide anti-pyretics for fever control.
Ensure adequate systemic hydration.
Offer oral analgesics or local throat lozenges.

💊 Recommended Dosage (Adult Outpatient)

Indicated if the calculated Strep score is ≥ 3 along with matching clinical suspicion.

Antibiotic Choice	Dosing Regimen	Duration	Status
Phenoxymethylpenicillin (Pen V)	500mg PO q6h OR 1gm PO q12h	5 – 10 Days*	Preferred
Amoxicillin	500mg PO q8h	5 – 10 Days*	Preferred
Erythromycin Ethylsuccinate	800mg PO q12h	5 – 10 Days*	Alternative

*Rheumatic Fever Guardrail: Consider extending therapy to a full 10 days in clinical areas with a high baseline prevalence of rheumatic fever, or in any patient with an established personal history of rheumatic fever or rheumatic heart disease (RHD) aged between 3 and 21 years old.

👶 Recommended Dosage (Children Outpatient)

Weight-based antimicrobial dosing guidelines. Standard course duration is 10 days for all choices.

Antibiotic Choice	Weight-Based Dosing Regimen	Duration	Status
Phenoxymethylpenicillin (Pen V)	25 – 50 mg/kg/day PO split q6h (Max: 2gm / day)	10 Days	Preferred
Amoxicillin	50mg/kg/day PO split q12h or q24h (Max: 1gm / day)	10 Days	Preferred
Cephalexin	25 – 50 mg/kg/day PO split q12h (Max: 2gm / day)	10 Days	Alternative
Erythromycin Ethylsuccinate	40 – 50 mg/kg/day PO split q12h (Max: 800mg / dose)	10 Days	Alternative