Next-Day Return to School with Strep Pharyngitis

Current guidelines recommend at least 24 hours of exclusion from school for children treated with antibiotics for streptococcal pharyngitis, even though prior studies suggest 18 hours may be enough. In a study at a single private pediatric practice, 111 children (age range, 2 to 17 years) with positive streptococcal rapid antigen detection tests and positive group A streptococcal cultures were given a dose of amoxicillin (50 mg/kg) and retested 12 to 23 hours later (the next morning).

Only 10 children (9%) had a positive rapid test or culture the next morning. The proportion of “treatment failures” did not vary significantly by the length of time since the first amoxicillin dose or whether children were given the day-2 dose of amoxicillin be…