A 19-year-old man presents to the university health clinic with a 2-day history of fever, severe sore throat, and painful swallowing. He reports no cough, rhinorrhea, or hoarseness. His temperature is 38.6°C (101.5°F), blood pressure is 118/76 mm Hg, and pulse is 98/min. Physical examination reveals enlarged, erythematous tonsils with whitish exudates and bilateral tender anterior cervical lymphadenopathy. A rapid antigen detection test for Group A *Streptococcus* is positive. The patient has no known drug allergies. Which of the following is the most appropriate antibiotic regimen?
- Oral penicillin VAnswer
- BOral amoxicillin-clavulanate
- COral levofloxacin
- DOral azithromycin
- EIntramuscular ceftriaxone
Answer
Oral penicillin V
The correct answer is oral penicillin V. Group A *Streptococcus* (Streptococcus pyogenes) is the most common bacterial cause of acute pharyngitis and remains universally susceptible to penicillin. Standard antibiotic stewardship guidelines recommend targeted, narrow-spectrum agents—such as oral penicillin V or amoxicillin—as first-line therapy to eradicate the pathogen, prevent rheumatic fever, and minimize the risk of developing broad-spectrum antimicrobial resistance.
Step-by-Step Solution
Key Concept
First-line treatment for confirmed Group A streptococcal pharyngitis is narrow-spectrum penicillin (or amoxicillin) to provide targeted therapy and minimize the development of antimicrobial resistance.
Estimated Time:45s