Strep Throat Treatment: Antibiotics and More

By Sarah Malka, MD
Medically reviewed
October 15, 2021

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.

Think you may have strep throat? Chat with a doctor today for just $23

Chat Now

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.

Causes 

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

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
  • Fever
  • Headache
  • Rash
  • 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. 

Risks

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:

Diagnosis

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. 

Common antibiotics

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.

Prevention

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.

Think you may have strep throat? Chat with a doctor today for just $23

Chat Now

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.

How K Health Can Help 

Did you know you can get affordable primary care with the K Health app?

Download K to check your symptoms, explore conditions and treatments, and if needed text with a doctor in minutes. K Health’s AI-powered app is HIPAA compliant and based on 20 years of clinical data.

Frequently Asked Questions

Does strep throat need antibiotics to be treated?
While strep throat typically goes away on its own without antibiotics, treatment with antibiotics can make symptoms improve in about 1-2 days and can prevent some complications.
Can antibiotics make strep throat worse?
No, antibiotics are a safe and effective treatment for strep throat. However, if your sore throat symptoms are due to a virus, antibiotics will not help and can make you feel worse. This is why it is important to be evaluated and get a strep test before starting antibiotics.
What do I do if antibiotics aren’t working for my strep throat?
If you feel your symptoms are getting worse or not improving on antibiotics within 2-3 days, contact your healthcare provider.
K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

K Health has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references.

Sarah Malka, MD

Dr. Sarah Malka is a board certified emergency medicine physician with K Health. She completed her residency at Harvard Medical School.