Editing Streptococcal pharyngitis (section)

===Antibiotics===
The antibiotic of choice in the United States for streptococcal pharyngitis is [[Phenoxymethylpenicillin|penicillin V]], due to safety, cost, and effectiveness.<ref name=Review09/> [[Amoxicillin]] is preferred in Europe.<ref>{{cite journal |vauthors=Bonsignori F, Chiappini E, De Martino M | title = The infections of the upper respiratory tract in children | journal = Int J Immunopathol Pharmacol | volume = 23 | issue = 1 Suppl | pages = 16–9 | year = 2010 | doi = 10.1177/03946320100230S105 | pmid = 20152073 | s2cid = 7272884 }}</ref> In India, where the risk of rheumatic fever is higher, intramuscular [[benzathine benzylpenicillin|benzathine penicillin]] G is the first choice for treatment.<ref name=Review10/>

Appropriate antibiotics decrease the average 3–5 day duration of symptoms by about one day, and also reduce contagiousness.<ref name="IDSAGuideline2002" /> They are primarily prescribed to reduce rare complications such as [[rheumatic fever]] and [[peritonsillar abscess]].<ref name="InternalMedPosition2001">{{cite journal | vauthors = Snow V, Mottur-Pilson C, Cooper RJ, Hoffman JR | title = Principles of appropriate antibiotic use for acute pharyngitis in adults | journal = Ann Intern Med | volume = 134 | issue = 6 | pages = 506–8 | date = March 2001 | pmid = 11255529 | doi = 10.7326/0003-4819-134-6-200103200-00018 | s2cid = 35082591 }}{{Update inline|?=yes|date=September 2016}}</ref> The arguments in favor of antibiotic treatment should be balanced by the consideration of possible side effects,<ref name="Review2001" /> and it is reasonable to suggest that no antimicrobial treatment be given to healthy adults who have adverse reactions to medication or those at low risk of complications.<ref name="InternalMedPosition2001" /><ref name=EB2015>{{cite journal|last1=Hildreth|first1=AF|last2=Takhar|first2=S|last3=Clark|first3=MA|last4=Hatten|first4=B|title=Evidence-Based Evaluation And Management Of Patients With Pharyngitis In The Emergency Department.|journal=Emergency Medicine Practice|date=September 2015|volume=17|issue=9|pages=1–16; quiz 16–7|pmid=26276908}}</ref> Antibiotics are prescribed for strep throat at a higher rate than would be expected from how common it is.<ref>{{cite journal |vauthors=Linder JA, Bates DW, Lee GM, Finkelstein JA | title = Antibiotic treatment of children with sore throat | journal = J Am Med Assoc | volume = 294 | issue = 18 | pages = 2315–22 |date=November 2005 | pmid = 16278359 | doi = 10.1001/jama.294.18.2315 | doi-access = free }}</ref>

[[Erythromycin]] and other [[macrolides]] or [[clindamycin]] are recommended for people with severe [[penicillin allergy|penicillin allergies]].<ref name="Review09" /><ref name="IDSA2012" /> First-generation [[cephalosporins]] may be used in those with less severe allergies<ref name="Review09" /> and some low-certainty evidence suggest cephalosporins are superior to penicillin.<ref>{{cite journal|last=Pichichero|first=M|author2=Casey, J |title=Comparison of European and U.S. results for cephalosporin versus penicillin treatment of group A streptococcal tonsillopharyngitis.|journal= [[European Journal of Clinical Microbiology & Infectious Diseases]] |date=June 2006|volume=25|issue=6|pages=354–64|pmid=16767482|doi=10.1007/s10096-006-0154-7|s2cid=839362}}</ref><ref>{{Cite journal |last1=Hedin |first1=Katarina |last2=Thorning |first2=Sarah |last3=van Driel |first3=Mieke L. |date=2023-11-15 |title=Different antibiotic treatments for group A streptococcal pharyngitis |journal=The Cochrane Database of Systematic Reviews |volume=2023 |issue=11 |pages=CD004406 |doi=10.1002/14651858.CD004406.pub6 |issn=1469-493X |pmc=10646936 |pmid=37965935}}</ref> These late-generation antibiotics show a similar effect when prescribed for 3–7 days in comparison to the standard ten days of penicillin when used in areas of low rheumatic heart disease.<ref>{{cite journal |last1=Altamimi |first1=Saleh |last2=Khalil |first2=Adli |last3=Khalaiwi |first3=Khalid A |last4=Milner |first4=Ruth A |last5=Pusic |first5=Martin V |last6=Al Othman |first6=Mohammed A |title=Short-term late-generation antibiotics versus longer term penicillin for acute streptococcal pharyngitis in children |journal=Cochrane Database of Systematic Reviews |date=15 August 2012 |issue=8 |pages=CD004872 |doi=10.1002/14651858.CD004872.pub3|pmid=22895944 }}</ref> Streptococcal infections may also lead to [[acute glomerulonephritis]]; however, the incidence of this side effect is not reduced by the use of antibiotics.<ref name="Review10" />