Can we shorten the duration of treatment for acute streptococcal pharyngitis?

Treatment of acute streptrococcal sore throat is advocated to hasten clinical resolution, prevent suppurative sequelae and decrease the incidence of rheumatic fever and glomerulonephritis. A 10-day course of penicillin is the standard treatment recommended for Group A beta hemolytic streptococci (GABHS) infection. Many antibiotics, including other beta lactams, macrolides, and clindamycin are also effective against streptococci and have the potential to shorten the duration of therapy. The present review was conducted with the objective of evaluating the efficacy of short course (2 to 6 days) of oral antibiotics in treating children with acute streptococcal pharyngitis, compared with a 10-day course of oral penicillin, on duration of symptoms (fever and sore throat), eradication of the organism, and, recurrence and complication rates (acute rheumatic fever and acute poststreptococcal glomerulonephritis).