In children with strep pharyngitis, does treating with broader spectrum antibiotics instead of penicillin reduce recurrence or complications?

Evidence-Based Answer A short term (3–6 day) course of oral antibiotics including azithromycin 20 mg/kg, clarithromycin, cefuroxime, and others (erythromycin, cefixime, amoxicillin, amoxicillin/clavulanate, penicillin V, cefprozil, cefpodoxime, josamycin, cefdinir, ceftibuten, loracarbef) has comparable efficacy to a 10-day standard course of oral penicillin in treating children with acute group A betahemolytic streptococcal (GABHS) pharyngitis. Shortterm late-generation antibiotics have better compliance but more mild-to-moderate, primarily gastrointestinal, adverse effects (SOR: A, systematic review of RCTs). Penicillin remains the recommended treatment (SOR: C, expert opinion).