Pharyngitis algo v1

  • Complaint of sore throat or pharyngitis on exam
    • Pain control per triage protocol
      • Symptoms suspicious for Group A strep?
        • No
          • Suspected Viral Pharyngitis?
            • Severe Symptoms?
              • No
                • Symptomatic Care
              • Yes
                • Further testing not routinely indicated.
                • Steroids not routinely recommended.
        • Yes
          • POCT rapid strep test
            • Is it positive?
              • No
                • Throat Culture, No Antibiotics (Routinely)
                  • Culture positive after 48 hours?
                    • No
                      • Culture negative at 48 hrs: Symptomatic Care
                    • Yes
                      • Penicilin Allergy?
                        • No
                          • Amoxicillin
                            • 50 mg/kg/day (max of 1 gram) OR
                            • 20 mg/kg BID (max 500 mg/dose x 10 days)
                          • Penicillin V
                            • < 27 kg 250 mg BID x 10 days
                            • > 27 kg 500 mg BID x 10 days
                          • Penicillin G
                            • < 27 kg 600,000 Units IM x 1
                            • > 27 kg 1.2 million Units IM x 1
                          • Symptomatic care
                        • Yes
                          • Azithromycin
                            • 12 mg/kg/day x 5 days (max of 500 mg/dose) OR
                          • Cephalexin
                            • 20 mg/kg/dose (max 500 mg/dose) BID x 10 days OR
                          • Clindamycin
                            • 7 mg/kg/doseTID x 10 days (max of 300 mg/dose)
                          • Symptomatic care
              • Yes
                • Penicilin Allergy?
                  • No
                    • Amoxicillin
                      • 50 mg/kg/day (max of 1 gram) OR
                      • 20 mg/kg BID (max 500 mg/dose x 10 days)
                    • Penicillin V
                      • < 27 kg 250 mg BID x 10 days
                      • > 27 kg 500 mg BID x 10 days
                    • Penicillin G
                      • < 27 kg 600,000 Units IM x 1
                      • > 27 kg 1.2 million Units IM x 1
                    • Symptomatic care
                  • Yes
                    • Azithromycin
                      • 12 mg/kg/day x 5 days (max of 500 mg/dose) OR
                    • Cephalexin
                      • 20 mg/kg/dose (max 500 mg/dose) BID x 10 days OR
                    • Clindamycin
                      • 7 mg/kg/doseTID x 10 days (max of 300 mg/dose)
                    • Symptomatic care

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