Which antibiotic is commonly used for streptococcal pharyngitis in penicillin-allergic patients?

Which antibiotic is commonly used for streptococcal pharyngitis in penicillin-allergic patients?

• A. Amoxicillin
• B. Dicloxacillin
• C. Azithromycin
• D. Penicillin V

Answer: (C)

When treating streptococcal pharyngitis in someone with a penicillin allergy, you need an option outside the beta-lactam class that still reliably covers group A Streptococcus. Azithromycin fits that need because it’s a macrolide with good activity against Streptococcus pyogenes and excellent oral bioavailability, plus a convenient dosing course. That makes it a practical and commonly used alternative when penicillin cannot be given. The other options are penicillins, which are avoided in penicillin-allergic patients due to potential allergic reactions, so they’re not suitable in this scenario. Keep in mind that resistance patterns can vary by region, so clinicians may opt for other non–beta-lactam choices like clarithromycin or, in some cases, clindamycin if needed.

When treating streptococcal pharyngitis in someone with a penicillin allergy, you need an option outside the beta-lactam class that still reliably covers group A Streptococcus. Azithromycin fits that need because it’s a macrolide with good activity against Streptococcus pyogenes and excellent oral bioavailability, plus a convenient dosing course. That makes it a practical and commonly used alternative when penicillin cannot be given. The other options are penicillins, which are avoided in penicillin-allergic patients due to potential allergic reactions, so they’re not suitable in this scenario. Keep in mind that resistance patterns can vary by region, so clinicians may opt for other non–beta-lactam choices like clarithromycin or, in some cases, clindamycin if needed.