While uncomfortable, a sore throat on its own is not always cause for alarm and can often be treated with over-the-counter and home remedies.
But when accompanied by other symptoms, a scratchy, painful throat may be a sign of an infection.
If it’s strep throat, antibiotics can help, but if it’s a viral infection, antibiotic treatment not only doesn’t work, it could cause unnecessary side effects.
Luckily, doctors can easily test for strep throat and recommend the appropriate treatment to help you feel better quickly.
In this article, I’ll cover the causes, symptoms, and risks of strep throat, as well as how healthcare providers diagnose the infection.
Then I’ll explain which antibiotics work to treat strep throat, how to prevent the infection, and when to see a doctor about your sore throat.
Strep Throat Basics
Strep throat (also known as streptococcal pharyngitis) is a bacterial infection that can cause a painful sore throat and high fever.
Unlike sore throat caused by allergies or a virus, a sore throat caused by strep throat comes on quickly and is often accompanied by fever, swollen tonsils, and enlarged lymph nodes.
People with strep rarely have a cough, runny nose, mouth sores, or hoarseness; instead, those are signs of a viral illness.
Though anyone can get strep throat, it’s most common in children between the ages of 5-15.
It’s also most commonly spread in late autumn and early spring, though it is possible to get it year-round.
Most sore throats are caused by viruses, but strep throat is a bacterial infection caused by bacteria called A Streptococcus (or group A strep).
Group A strep is contagious and can spread easily between people through close contact or touching contaminated items or surfaces.
Symptoms of strep throat usually appear 2-5 days after being in close contact with an infected individual or the bacteria itself.
Most cases are mild, but in some instances, strep throat can be very painful.
The most common symptoms of strep throat are:
- Throat pain that comes on quickly
- Pain when swallowing
- Red, swollen tonsils
- Small red spots on the roof of the mouth
- White pus on the tonsils
- Tender, swollen lymph nodes
- Nausea or vomiting, particularly in younger children
- Body aches
Keep in mind, a sore throat accompanied by cough or congestion is usually a sign of a viral infection rather than strep throat.
If you or your child are experiencing any symptoms of strep throat, it’s important to speak to your provider as soon as possible so that you can start treatment and prevent complications.
If left untreated, strep throat can pose some serious risks, including:
- Sinus infection (sinusitis)
- Kidney problems
- Rheumatic fever
- Pediatric autoimmune neuropsychiatric disorder (PANDAS)
Diagnosing strep throat often requires an in-person visit with your doctor.
After a physical exam, your provider may choose to perform a rapid antigen test to check for the presence of group A strep bacteria.
During this test, they gently swipe your throat with a swab to collect a sample to test.
The results come back quickly: Most providers are able to confirm a diagnosis and prescribe antibiotic treatment in the same visit.
If your rapid strep test is negative, your doctor may perform a more sensitive throat culture to be completely sure you don’t have strep throat.
For a throat culture, they swab your tonsils and the back of your throat.
These test results often take longer, sometimes up to two days, to come back. It is OK to wait for those results before starting treatment.
Treating Strep Throat with Antibiotics
Oral antibiotics are the most common and effective treatment for strep throat.
These can work to slightly reduce the duration and severity of symptoms, prevent complications, and limit the spread of infection to others.
Sore throat may persist for up to a week even with antibiotic treatment, but antibiotics decrease the duration of symptoms by about one day, and should prevent symptoms from worsening within 2-3 days.
You should never be given antibiotics without a positive diagnosis of strep via testing or evaluation by a licensed healthcare provider.
If your strep test is negative, your symptoms are likely caused by a virus and antibiotics will not help and instead may be harmful.
The most common antibiotic treatment for strep throat is penicillin or amoxicillin.
For people who are allergic to penicillin and penicillin-based antibiotics, the recommended treatment is cephalexin or other similar cephalosporins, clindamycin, or azithromycin.
Several strategies can help prevent you and your family from getting strep throat:
- Wash your hands frequently: Regular hand washing with soap and water—especially during strep season—can help to prevent strep infection. When you can’t wash your hands, use an alcohol-based hand sanitizer.
- Practice good hygiene: Cover your nose and mouth when coughing and sneezing, and limit the sharing of personal items such as water bottles and food utensils.
- Limit contact with people who are sick: When possible, avoid direct contact with someone while they are infected with strep throat.
When to See a Doctor
Speak with a provider as soon as you or your child are experiencing any symptoms of strep throat.
If your provider confirms the diagnosis, they can prescribe the right antibiotic prescription to clear the infection.
If you’re still feeling unwell two days after starting the medication, let your provider know.
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