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Single amoxicillin dose for strep throat allows next-day return to school
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The majority of students with group A streptococcal pharyngitis treated with a single dose of amoxicillin tested negative for the infection within 24 hours, making them able to return to school the following day, according to a recent study.
“The purpose of this study was to re-evaluate the necessity of the 24-hours of antibiotic treatment for group A streptococcal pharyngitis before permitting return to school,” researcher Richard H. Schwartz, MD, of the department of pediatrics at the Inova Children’s Hospital, Falls Church, Virginia, and colleagues wrote. “We conclude that all children treated with amoxicillin for streptococcal pharyngitis by 5 p.m., if afebrile and improved, may be permitted to attend school on day 2.”
To determine whether a single dose of amoxicillin (50 mg/kg) effectively diminished strep throat, the researcher analyzed a cohort of 111 children aged 2 to 17 years with sore throat plus a positive rapid antigen detection test. The cohort was divided into patients who received only an initial dose of amoxicillin before a return visit the next day (n =51) and patients who received a second-dose of amoxicillin 1 hour before visiting researchers the next day (n = 60).
Study results showed that after follow-up, only 9% of patients tested positive for strep throat. There were six failures in the group that received the second dose before being tested on day 2 and four failures in the group that did not. Of these 10 patients, seven had a significant decrease in strep throat after a second throat culture.
Schwartz and colleagues suggested that these findings be used to change state regulations requiring a 24-hour treatment period before authorizing students to return to school after a positive strep throat culture. These changes could impact the lives of families without access to child-care in emergency situations, the investigators said.
“The potential for significant financial savings and improved school attendance, as well as potential reduction in sick day absences for a working (outside the home) parent, may be significant,” the researchers wrote. – by David Costill
Disclosure: The researchers report no relevant financial disclosures.
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