What is the first-line treatment for acute pharyngitis caused by Streptococcus pyogenes?

The first-line treatment for acute pharyngitis caused by Streptococcus pyogenes, commonly known as Group A Streptococcus, is penicillin or amoxicillin. This choice is well-supported because penicillin is highly effective against this bacterial pathogen, with a proven track record of efficacy in treating streptococcal pharyngitis. These antibiotics work by targeting the bacterial cell wall, leading to cell lysis and death. Penicillin remains the drug of choice due to its excellent safety profile, low cost, and effectiveness.

Amoxicillin, a derivative of penicillin, is also frequently used because it has similar effectiveness but often comes in more palatable formulations for children. Since Streptococcus pyogenes is sensitive to penicillin, this treatment not only alleviates symptoms but also reduces the risk of complications, such as rheumatic fever and post-streptococcal glomerulonephritis.

While other antibiotics like azithromycin, ceftriaxone, and clindamycin may have activity against Streptococcus pyogenes, they are not considered first-line options for this specific indication. Azithromycin is often used in patients with penicillin allergy but doesn't have the same level of efficacy. Ceftria