For strep throat, 5-days zithromax is easy to use. are doctors seeing some antibiotic resistance? what's being used other than zithro, amoxil, (amoxicillin) or pcn?

Omnicef (cefdinir): Cefdinir (omnicef) is active against a very wide spectrum of bacteria, including staphylococcus aureus; streptococcus pneumoniae; streptococcus pyogenes (strep throat!); hemophilus influenzae; moraxella catarrhalis; e. Coli; klebsiella; and proteus mirabilis. It is not active against pseudomonas. For peds: great taste and dosing is easy (bid or daily).

Rare: There has been rare reported resistance to zithromycin (zithromax). Resistant strains were found back in 2002 in pittsburgh when 46 cases were demonstrated in a group of schoolchildren and scattered cases have been seen in multiple locales since then. Cephalosporins are useful and also used in strep carrier states too.

No: I am not aware of group a streptococci being resistant to penicillin. Not as sure regarding Azithromycin but I am skeptical this is a big issue.

YES IT IS: In april 2012 pittsburg reported an outbreak of resistant drug resistant strain of group a streptococcus to erythromycin.And it was written in new england journal of medicine that was the first stdy from us to show high prevalence of erythromycine resistant grp a strep the reserchers said this strain of bacteria will also be resistant to other macrolides like azithromycine.

Resistant strep : Fortunately, resistance to antibiotics is very rare with streptococcus progenies, the bacterium that causes strep throat. The antibiotic of choice is still Penicillin VK or amoxicillin. If penicillin allergy is present, the use of Erythromycin is acceptable. Azithromycin should be used in double the standard dose for strep throat.

Keflex: Pcn still drug of choice, many recommend 1st generation cephalosporins amox always runs risk of drug rash if concomittant ebv omnicef tastes good, good compliance but pretty broad coverage, many insurances may not cover cost.

Some resistance: In my area (Long Island, NY) we do see some resistance to amoxicillin. I would say the success rate is 87-90%. I have started to use cefadroxil as a first line with a much better success rate. Also, depending on the size of the child, it can be dosed once a day which greatly improves compliance. Zithromax is OK, but remember to use 12mg/kg for all 5 days.