HOW IS STREP THORAT TREATED?

* Be aware that the recommended treatments of illnesses are always being improved. This website was last update on 11/1/2024. The best treatment option MIGHT have changed since that time.

Oral Medication
Penicillin VK 500 mg q 12 hours x 10 day # *
Amoxicillin 500 mg q 12 hours x 10 days # *
Keflex * 500 mg q 12 hours x 10 days #
Azithromycin * 500 mg once a day x 5 days #
Clarithromycin * 250 mg 2x / day x 10 days #
Erythromycin *
Cefadroxil * (Duricef)
Clindamycin *

Intramuscularly:
Penicillin G Benzathin 600,000 - 1.200,000 units (depending on weight) #

If the palentine tonsils are large and there is a danger of dehydration oral cortisone can be considered:
Medrol dose pak (for intense pain)
Prednisone Low dose (for intense pain)
Dexamethasone 10 mg once (for intense pain)

CAUTION:

1. There are other organism beside group A Beta Hemolytic Streptococcus that can cause a sore throat. These causes must be ruled out to a reasonable degree. Some of these causes are viruses. The respiratory viruses (Rhinovirus, Adenovirus, Influenza, Coronavirus, Respiratory Syncytial Virus) are the most common viral causes, but occasionally Epstein-Barr Virus (the cause of Mononucleosis), Herpes Simplex, Cytomegalovirus, or Primary HIV infection is involved.

2. An Abscess close to the tonsil called a Peritonsillar Abscess must also be ruled out. The abscess is usually on one side of the throat and causes the uvula to move to onside of the throat. However, the cause is still Strep—but it will usually not respond to oral antibiotics alone. Rarely these sore throats may be caused by a bacteria called Haemophilus Influenzas Type B (HIB). This can occur when a person has not been vaccinated to prevent HIB. Sometime HIV will cause epiglottis, which is an extremely painful sore throat, and may diminish a person’s ability to breathe.

3. A terrible complication of an abscess is Lemierre’s Syndrome. From a throat abscess the infection can be transferred to the jugular vein and then cause a blood clot. This usually causes terrible one sided pain.

4. There are still other bacteria infection that can cause a sore throat such as Gonorrhea, Syphiis, Apthous Ulcers, and certain medications such as those used for blood pressure (ACE Inhibitors, e.g. Lisinopril).

5. Although antibiotic pills are usually effective to treat Strep Throat, they are NOT always effective. If you are not starting to feel better after 24 hours on an antibiotics, call your provider. You may need a change of medication.

6. All medication, including all antibiotics, have a risk of side effects.
7. Possible mild side effects are nausea, vomiting, diarrhea, itching, and light skin rash.

8. Possible severe side effects are a sever rash, an anaphylactic allergic reaction (leading to the inability to breathe and subsequent death if not treated rapidly), or a Clostridioides difficile infection (C-Diff).

Consult “Epocrates.com” for each Specific Medication’s possible “Adverse Reactions.” Side effects are also referred to as “Adverse Reactions.” Epocrates.com will tell you both “common reactions” and “serious reactions.” You will have to create an account, but it is simple, fast, and free.

WHAT ARE THE SYMPTOMS OF STREP THROAT (STREPTOCOCCAL PHARYNGITIS)?

Symptoms of Strep Throat can vary from mild to severe. The most common symptoms are quick onset of a painful thorat and a fever, without symptoms such as runny nose (rhinorrhea) and cough. The back of the throat (pharynx) is usually red, and there may be swollen tonsil in the back of the mouth (Palentine tonsils) that have white or yellow pus in the middle of the tonsils. If there is fever, there will also be usually be body aches. A headache is also common. If a Strep Throat occurs in a young child, they often will have nausea and vomiting. A rash is also somewhat common.

WHAT IS THE CAUSE OF STREP THROAT?

The cause of Strep Throat is Group A Beta-Hemolytic Streptococci. Group A Beta-Hemolytic Streptococci Bacteria is spread through contact with droplets from an infected person when they talk, cough, or sneeze. If you touch your mouth, nose, or eyes after touching something that has these droplets on it, you may become ill.

HOW IS STREP THROAT DIAGNOSED?

Strep throat is often diagnosed by taking a careful history and making a visual inspection. There are several test that can be done if there is doubt about the diagnosis. These tests obtain a specimen from the back of the throat with a swab. That specimen can be tested in the office or can be sent to a lab for testing. These are relatively accurate- but are not perfect.