What are the first-line antibiotics for treatment of group A strep pharyngitis?

For the treatment of group A streptococcal (GAS) pharyngitis, the first-line antibiotics are penicillin V and amoxicillin. These antibiotics are highly effective against Streptococcus pyogenes, the bacterium responsible for this type of throat infection.

Penicillin V is the traditional choice due to its narrow spectrum of activity, effectiveness against the bacteria, and favorable safety profile. Amoxicillin is often preferred because it can be more palatable for children and has similar efficacy as penicillin for treating this condition. The use of these antibiotics leads to a quick resolution of symptoms and also significantly reduces the risk of complications, such as rheumatic fever.

Other antibiotic options may be used in cases where patients are allergic to penicillin, but they do not represent the first-line treatment.