Strep throat treatment

The main goal in the treatment of strep throat is to reduce a patient’s length and severity of symptoms, as well as to avoid acute and delayed complications and the spread of infections to others.

If formally diagnosed with strep throat, a provider will treat the person with oral antibiotics, most likely penicillin or amoxicillin.

These medications are commonly used since they are relatively low-cost and typically have a low negative impact on those prescribed. Children can take 250 mg of penicillin twice or three times daily, and adults can 250 mg four times daily.

Patients with allergies to penicillin can be treated with clindamycin¹⁷, clarithromycin¹⁸, or azithromycin¹⁹. Clindamycin is considered the first alternative for patients with a penicillin allergy that causes anaphylaxis. Clarithromycin and azithromycin are secondary options, as Group A strep can be resistant to these agents. In addition, patients who do not have an anaphylactoid²⁰(allergic) reaction to penicillin can be treated most commonly with cephalexin and cefadroxil²¹.

What else can you do?

As well as receiving antibiotic treatment for strep throat, it is important to drink plenty of fluids, rest, eat soft foods, and take acetaminophen or an NSAID to improve the symptoms associated with strep throat.

You can also create moisture in your environment with a humidifier and should stay away from irritants such as cigarette smoke.

Over-the-Counter Painkillers

The following can be taken to alleviate discomfort associated with strep throat:

• NSAIDs (nonsteroidal anti-inflammatory drugs): used to treat pain and fever. Includes ibuprofen (Advil, Motrin) and naproxen (Aleve)
• Acetaminophen (Tylenol): a pain reliever and fever reducer. Do not exceed 4g/day in adults and 75mg/kg/day in children.

Be sure to consult with your provider about the right dosage of any over-the-counter medicines for your child.

Strep throat medications

Because strep throat is a bacterial infection, it is treated with antibiotics. While it is important to take all medications as directed, it is critical that you complete all doses of a prescribed antibiotic to fully treat your illness and prevent antibiotic resistance (developing an infection that can’t easily be treated with antibiotics).

Complications from strep throat

If left untreated, strep throat can lead to a number of complications.

Sometimes, strep bacteria can spread, causing infections in the tonsils, sinuses, skin, blood, or middle ear. Strep can also lead to inflammatory illnesses, including scarlet fever, kidney inflammation, rheumatic fever, and poststreptococcal reactive arthritis.

Rare suppurative (pus-forming) infections can occur in adjacent structures. These infections can occur in the tonsils, the back of the throat, the cervix, and behind the ear. If you or your child develop any further symptoms after receiving treatment for strep throat, seek medical care immediately.

Serious complications caused by strep throat can rarely occur. Immediate medical care is required for any of the following:

• Post-streptococcal glomerulonephritis (PSGN²²): pharyngitis (sore throat) or skin infections caused by strep strains that cause kidney inflammation
• Rheumatic fever: fever affecting multiple organ systems, namely the heart
• Brain abscess: a serious infection that crosses the blood-brain barrier
• Jugular vein septic thrombophlebitis: jugular vein blood clotting
• Streptococcal toxic shock syndrome (STSS²³): causes high fever, low blood pressure, vomiting, and rash
• Otitis media: a group of inflammatory diseases of the middle ear
• Tonsillopharyngeal cellulitis: an inflammatory reaction between the tissue of the palatine tonsil and pharyngeal muscles
• Acute glomerulonephritis: inflammation and damage of nerve endings and blood vessels in capillary clusters
• Scarlet fever: a red rash that spreads, often accompanied by high fever

Strep throat prevention

If you or your child has strep throat, take the proper steps to avoid spreading the infection. Strep throat can be prevented with respiratory etiquette and good hygiene²⁴.

Follow respiratory etiquette

If you have strep throat, it’s important to prevent the spread of strep bacteria in your mucus or saliva caused by sneezing or coughing.

In order to prevent the spread of bacteria, use good respiratory etiquette. If you don’t have a tissue, cover your cough or sneeze with your inner elbow. Using your hands to do so causes bacteria to spread when you touch other surfaces or people.

Maintain good hygiene

Always wash your hands with warm, soapy water after coughing or sneezing and before preparing foods or eating.

When you or someone in your family is ill, you should take special care to disinfect surfaces or objects they have touched, especially after they have been coughing or sneezing.

When possible, avoid close contact and sharing food or drinks with someone infected with strep throat.

Stay at home

A person infected with strep is generally no longer contagious after receiving 24 hours of antibiotic treatment.

However, you or your child should avoid going to work, school, or public places until you no longer have a fever and you have taken antibiotics for a full 24 hours.