TY - JOUR T1 - Phenoxymethylpenicillin or amoxicillin for paediatric tonsillopharyngitis: a case of head versus heart? JF - Archives of Disease in Childhood JO - Arch Dis Child DO - 10.1136/archdischild-2020-320995 SP - archdischild-2020-320995 AU - Michael Malley AU - Isla Monaghan AU - Katie Driver AU - Megan Costelloe AU - Lucy Jefferson AU - Louise Poole AU - Cliona Lewis AU - Rachael Salt AU - Robin Marlow Y1 - 2021/02/25 UR - http://adc.bmj.com/content/early/2021/02/25/archdischild-2020-320995.abstract N2 - Debate exists regarding antibiotic choice and treatment rationale in paediatric bacterial tonsillopharyngitis. To prevent potential complications of Group-A streptococcal (GAS) infection, which are rare in developed settings, the UK National Institute of Health and Care Excellence (NICE) recommends treating suspected GAS infections with 5–10 days’ phenoxymethylpenicillin (pen-V) using FeverPAIN or Centor criteria to identify bacterial aetiology.1While updating local guidelines, we successfully contacted 153 of 180 (85%) English emergency departments (ED) to establish national practice. While 137 (90%) units use pen-V first-line, variation exists in dosing schedule and indication (table 1). Eleven units (7%) use amoxicillin and four (3%) offer both. For antibiotic rationalisation, 50% of units used clinical decision tools (FeverPain/Centor), 46% used no system and 4% reported using rapid GAS testing.View this table:In this windowIn a new windowTable 1 Reported prescribing practice for suspected … ER -