Is a short-course antibiotic treatment effective for streptococcal tonsillopharyngitis in children?

Acute bacterial tonsillopharyngitis in children has been classically treated with long courses of antibiotic, usually 10 days, with the intention to prevent the occurrence of complications. However, it has not been clarified whether a shortened treatment could be equally effective in fulfilling that purpose. To answer this question, we searched in Epistemonikos database, which is maintained by screening multiple databases. We identified five systematic reviews including 59 randomized trials overall. We extracted data, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. We concluded that a shortened antibiotic regimen is probably similar, or with minimal differences, to a longer course, and might not make any difference regarding complications related to Streptococcus group A infection.