Streptococcus pyogenes Tables

Table 1. In Vitro Susceptibilities of Streptococcus pyogenes to Common Antibiotics

Table 2. Suggested Antibiotics, Doses and Duration For Treatment of Streptococcus pyogenes Infections [Download PDF]

	Suggested Therapy
Infection Type	Primary	Alternative	Duration

Pharyngitis	Penicillin Amoxicillin	Erythromycin Clindamycin	10 days
Soft tissue Cellulitis	Dicloxicillin Cephalexin	Clindamycin Erythromycin	10 days 14 days
Impetigo Erysipelas	Penicillin	Erythromycin Clindamycin	10 days
Necrotizing fasciitis	Nafcillin plus Clindamycin	Vancomycin plus Clindamycin	14 days
Myositis	Nafcillin plus Clindamycin (*add Clindamycin if toxic patient)	Vancomycin Cefazolin	10-14 days
Lymphangitis	Dicloxicillin Cefazolin	Clindamycin Vancomycin	10 days
Puerperal sepsis	Clindamycin plus Gentamicin	Cefoxitin	10 days
Vulvovaginits	Penicillin Amoxicillin	Cephalexin Erythromycin	10 days
Omphalitis	Ampicillin-Sulbactam	Vancomycin Clindamycin	10 days
Streptococcal Toxic Shock Syndrome	Nafcillin plus Clindamycin	Vancomycin plus Clindamycin	10 – 14 days
Bacteremia	Penicillin Ampicillin	Cefazolin Vancomycin	10 – 14 days
Pneumonia	Penicillin Ampicillin	Clindamycin Cefazolin Vancomycin	10 – 14 days
Peritonsillar Abscess or Cellulitis	Clindamycin Ampicillin-Clavulanic Acid	Cefazolin	10 days
Retropharyngeal Abscess	Ampicillin-Sulbactam Penicillin plus Clindamycin		14 days
Meningitis	Nafcillin plus Clindamycin	Vancomycin plus Clindamycin	10 – 14 days
Endocarditis	Penicillin Ampicillin		4-6 weeks
Osteomyelitis	Penicillin Nafcillin	Clindamycin Cefazolin Vancomycin	21 days

IV Doses:

Ampicillin 2 gm IV q 6° Gentamicin 2 mg/kg IV q 8°

Ampicillin-Sulbactam 2 gm (of Amp) IV q 6° Nafcillin 2.0 gm q 4° IV

Cefazolin 2.0 gm q 8° IV Penicillin G 1-4 million units IV q 6°

Cefoxitin 2 gm IV q 6° Vancomycin 1.0 gm q 12° IV

Clindamycin 900 mg q 8° IV

Oral Doses:

Amoxicillin 500 mg p.o. bid Dicloxicillin 500 mg p.o. qid

Amoxicillin-Clavulanic Acid 875 mg p.o. bid Erythromycin 150-250 mg p.o. tid

Cephalexin 250-500 mg p.o. qid Penicillin V 500 mg p.o. bid

Clindamycin 300 mg p.o. qid