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Strep throat infections are not as common as sore throat infections caused by viruses. Caused by streptococcal bacteria, strep throat infections affect only one in four school-aged children and 5-20% of adults who have a sore throat. Sore throats caused by viruses often do not require antibiotic treatment and may get better on their own with conventional home treatments.

However, it is important to identify strep throat infections because these may lead to more serious complications.

Although many cases of strep throat resolve even without treatment, some experts argue that antibiotic treatment may help prevent its spread and avoid long-term complications.

Symptoms and Diagnosis

Symptoms of strep throat are somewhat similar to viral sore throats. These include fever and painful, irritated throat. Symptoms that resemble colds and flu (runny nose, sneezing, coughing) are associated with viral infections while a sudden onset of severe sore throat with high fever, inflamed tonsils and neck nodes are more characteristic of a bacterial strep infection.

Depending on their clinical findings, physicians may recommend a throat swab and culture to determine if a patient is suffering from strep throat. Rapid antigen detection testing (RADT) may also be done. From the results of their evaluation, they may decide to administer antibiotic treatment to prevent serious complications. These include spread of bacteria to the ears (otitis media), to the brain (meningitis), to the mastoids (mastoiditis), to the lungs (pneumonia), or to the rest of the body (bacteremia). Long-term complications include rheumatic fever, which may affect the heart, and chronic kidney disease from poststreptococcal glomerulonephritis. These complications arise from the intense immune reaction which causes the body to attack itself, causing organ damage.


The antibiotic of choice in strep throat infections is penicillin, which can be taken by mouth injected into the muscle. However, physicians may also prescribe amoxicillin, which is more palatable to children and is available in chewable tablet form.

Some people are allergic to penicillin, so if you know you are allergic to this drug, ask the doctor to give you a suitable substitute such as cephalexin (Keflex), which is a cephalosporin, clarithromycin (Biaxin), clindamycin, or azithromycin (Zithromax). Antibiotics kill bacteria and reduce the severity and duration of illness. Patients usually feel better one or two days after taking antibiotics. However, if you or your child does not feel better two days after antibiotic treatment, call your doctor for further evaluation.

Aside from reducing symptoms, antibiotic treatment also prevents the spread of bacteria to other people and reduces your risk of experiencing complications of strep infection. However, even if you feel better a few days after taking these medications, continue to take them as directed. Not finishing the entire course of treatment may cause recurrence of infection and may lead to serious complications.

Other medicines used to treat symptoms of strep throat include acetaminophen and ibuprofen to relieve fever and sore throat. It is advisable also to get some bed rest to allow the body to heal and to prevent spreading the infection to others. Doctors recommend increasing fluid intake by drinking water or herbal teas. Increasing the moisture in the air of your room (humidity) and gargling with warm saline solution several times a day will also help soothe your throat.

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