Final answer:
Treatment for GAS pharyngitis often begins with amoxicillin or penicillin G. For those allergic to penicillin or with recurrent cases, alternatives include macrolides or cephalosporins, which aim to prevent complications like acute rheumatic fever.
Step-by-step explanation:
Treatment for Group A streptococcus (GAS) pharyngitis, commonly known as strep throat, involves antibiotics to prevent serious sequelae such as acute rheumatic fever. The initial treatment usually includes oral amoxicillin or intramuscular penicillin G. In instances of recurrent infection or penicillin allergy with anaphylaxis, alternative antibiotics such as macrolides or cephalosporins may be used. Monitoring and managing comorbidities, including arthritis and carditis which are associated with acute-phase proteins released during infection, are also essential aspects of care.
For those with a penicillin allergy, antimicrobial management typically involves the use of macrolides like azithromycin or clarithromycin. Cephalosporins can be considered as well, assuming no cross-allergy with penicillins. In every case of GAS pharyngitis, the aim is to eliminate the bacterium, alleviate symptoms, and prevent potential complications, including the nonsuppurative sequelae like acute rheumatic fever and acute glomerulonephritis which may develop a few weeks after the primary infection.