Oh come on!  There is nothing new about clarithromycin (Biaxin).  It was
not necessary to stop then, and not necessary to stop now.  But this is
the sort of rigidity in physicians that makes us such sitting ducks for
the drug reps.  There is no reason at all to suspect that clarithromycin
is better for strep than azithromycin.

You really want to get rid of strep: rifampin plus clindamycin.  But do
you really want to get rid of it?  Don't do it.  Just because strep
grows in the throat, it does not mean that it is causing a problem.
Twenty percent of school age children have strep in their throats at
this time of the year, and most do not have symptoms.

Let's try to remember why we treat strep throats in the first place.  It
is to prevent rheumatic fever.  It does nothing for the throat pain.  If
the person is treated, the rheumatic fever is prevented, whether the
strep comes back again or not as a colonizer.  The best treatment is not
to redo throat swabs.

Jack Newman, MD, FRCPC