不是长效的。2012年的IDISA（美国传染病协会）的推荐，可以使用一次性的青霉素G肌肉注射60万单位（小于60磅体重的）

大于60磅体重的一次性注射是 120 万单位。认为对于咽部的Strep感染有强效。。。

Treatment

Patients with acute group A streptococcal pharyngitis should be treated with an antibiotic that is likely to eradicate the organism, usually for 10 days. Penicillin or amoxicillin is commonly recommended because of its narrow spectrum of activity, few adverse effects, and modest cost. Alternative antibiotics for those with penicillin allergy include a first-generation cephalosporin, clindamycin, clarithromycin (Biaxin), or azithromycin (Zithromax). Table 2 summarizes antibiotic regimens for patients with and without penicillin allergy.

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Table 2.

Treatment Regimens for Group A Streptococcal Infection

DRUG	DOSE/DOSAGE	DURATION	RECOMMENDATION STRENGTH, QUALITY OF EVIDENCE
Patients without penicillin allergy
Penicillin V, oral	Children: 250 mg two or three times daily	10 days	Strong, high
	Adolescents and adults: 250 mg four times daily or 500 mg twice daily
Amoxicillin, oral	50 mg per kg once daily (maximum = 1,000 mg)	10 days	Strong, high
	Alternative: 25 mg per kg twice daily (maximum= 500 mg)
Penicillin G benzathine, intramuscular	< 60 lb (27 kg): 600,000 U	Single dose	Strong, high
	≥ 60 lb: 1,200,000 U
Patients with pencillin allergy
Cephalexin (Keflex), oral*	20 mg per kg per dose twice daily (maximum = 500 mg per dose)	10 days	Strong, high
Cefadroxil, oral*	30 mg per kg once daily (maximum = 1 g)	10 days	Strong, high
Clindamycin, oral	7 mg per kg per dose three times daily (maximum = 300 mg per dose)	10 days	Strong, moderate
Azithromycin (Zithromax), oral†	12 mg per kg once daily (maximum = 500 mg)	5 days	Strong, moderate
Clarithromycin (Biaxin), oral†	7.5 mg per kg per dose twice daily (maximum = 250 mg per dose)	10 days	Strong, moderate

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*—Avoid in individuals with immediate hypersensitivity to penicillin.

†—Resistance of group A streptococcus to these agents is well-known and varies geographically and temporally.

Adapted with permission from Shulman ST, Bisno AL, Clegg HW, et al. Clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis: 2012 update by the Infectious Diseases Society of America. Clin Infect Dis. 2012;55(10):e89.