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Updated: Jun 8, 2026

Antibiotic Dereplication Using the Antibiotic Resistance Platform
Published on: October 17, 2019
Different antibiotic treatments for group A streptococcal pharyngitis
Mieke L van Driel1, An Im De Sutter, Natalija Keber
1Department of General Practice and Primary Health Care, Ghent University, Ghent, Belgium and, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia, 4229.
Penicillin remains a recommended first-choice antibiotic for group A beta-haemolytic streptococci (GABHS) tonsillopharyngitis due to its cost-effectiveness and lack of resistance. Evidence for other antibiotics shows limited benefits for specific outcomes in adults and children.
Area of Science:
- Infectious Diseases
- Pharmacology
- Otolaryngology
Background:
- Antibiotics offer limited benefit for sore throats, with increased efficacy for group A beta-haemolytic streptococci (GABHS) infections.
- Optimal antibiotic choice for GABHS tonsillopharyngitis remains unclear.
Purpose of the Study:
- To compare the efficacy of various antibiotics for GABHS tonsillopharyngitis.
- To evaluate clinical outcomes, relapse rates, complications, and adverse events.
Main Methods:
- Systematic review of randomized, double-blind trials.
- Searched Cochrane Library, CENTRAL, MEDLINE, and EMBASE databases.
- Included trials comparing different antibiotics for GABHS tonsillopharyngitis.
Main Results:
- Seventeen trials involving 5352 participants were analyzed.
- Cephalosporins showed reduced relapse rates in adults; carbacephem improved symptom resolution in children.
- No significant differences were found between macrolides and penicillin; data on complications were scarce.
Conclusions:
- Insufficient evidence exists to support clinically significant differences between antibiotics for GABHS tonsillopharyngitis.
- Penicillin is recommended as a first-choice due to cost and low resistance.
- Limited evidence suggests cephalosporins for adult relapse and carbacephem for pediatric symptom resolution.
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Acute Pharyngitis
Acute pharyngitis is the inflammation of the back of the throat (pharynx), commonly resulting in a sore throat. It is a frequently encountered condition that prompts individuals to seek medical advice.
Classification
Acute pharyngitis can be categorized based on its underlying cause:
Streptococcal Pharyngitis
Tonsillitis II: Management
Inhibitors of Gram-positive Cell Wall Synthesis
Acute Pyelonephritis II: Diagnostic Studies and Management
Inhibitors of Bacterial Protein Synthesis