short course penicillin for strep?
A recent Swedish study found that a 5-day course of penicillin for strep pharyngotonsillitis is not inferior to a standard 10-day course (see strep shortcourse pcn bmj2019 in dropbox or doi.org/10.1136/bmj.l5337) Details: --433 patients > 6yo with pharyngotonsillitis from 17 primary healthcare centers in Sweden, from 2015-18 --all had infection from Group A streptococci documented by a positive rapid antigen plus 3 or 4 Centor criteria (fever >38.5C, tender lymph nodes, coatings of the tonsils or inflamed tonsils in children, absence of cough) --63% female; median age 30 (17% <12yo/8% 13-17yo; 75% >17yo); Centor criteria 3 in 50%/4 in 50%; fever >38.5C in 75%/tender nodes 92%/tonsillar coating 87%/absence of cough 95%; median duration of symptoms: 3 days; severity per patient assessment: 59% severe/38% moderate/4% mild; effect on patient overall: mild 31%, moderate 68% --randomized to Pen V 800mg 4x/d for 5 days or 1000mg...