Suspect amoxicillin-resistant Streptococcus pyogenes? Begin with a rapid antigen detection test (RADT) followed by a throat culture for definitive identification and antibiotic susceptibility testing. This two-pronged approach ensures accurate diagnosis and guides treatment decisions.
While RADTs offer rapid results, their sensitivity varies. A negative RADT, especially with strong clinical suspicion, mandates throat culture. Culture allows for identification of the specific bacterial strain and precise determination of its antibiotic susceptibility profile, eliminating guesswork. This precise approach is vital for patient care.
For confirmed amoxicillin-resistant strep pharyngitis, penicillin remains a cornerstone treatment option, with clinical experience demonstrating high cure rates. However, a longer treatment duration (10-14 days instead of the typical 7 days) might be required. Consider alternative antibiotics, such as clindamycin or cephalexin, especially in case of penicillin allergy or treatment failure.
Closely monitor the patient for clinical improvement. Persistent symptoms beyond 72 hours necessitate a reevaluation. Repeat culture to rule out other pathogens or verify initial findings. Early identification of treatment failure prevents complications.
