Treating strep throat
1. Oral antibiotics
Once a bacterial infection has been determined, a doctor will prescribe an oral antibiotic to prevent the potential spread of infection and help to reduce the severity and duration of symptoms. This ensures that the risk for complications is considerably reduced as well. Complications include sinus or ear infections, and rheumatic fever.
Although an infection may begin to clear within a day or two, a full course of treatment with antibiotics will need to be taken to ensure that all of the bacteria is killed off. If a full course is not taken, it can cause a recurring bacterial infection, which can often become more difficult to treat or clear with antibiotics (this is known as bacterial resistance).
Antibiotics which are commonly prescribed include penicillin, amoxicillin or cephalexin. Penicillin can be given orally for a period of 10 days or a once-off injection (if oral medications are not tolerated well). An alternative to penicillin is Cephalosporins, a class of antibiotic which is also effective for the treatment of strep throat. For those who may have an allergy to penicillin, macrolides (antibiotics) may be prescribed instead.
Taking antibiotics may not make a person necessarily feel well again, even though the medication is targeting the bacteria in the body causing infection. It is common to experience some side-effects with antibiotic treatment.
Most side-effects are fairly mild. These include:
- Stomach upsets or tummy aches
- Loss of appetite
- Diarrhoea (this can be prevented by taking a course of probiotics simultaneously)
If side-effects become severe, it is best to consult the doctor as soon as possible. In some cases, signs of antibiotic allergy can occur, such as a rash, rapid heartbeat, breathing difficulties and wheezing or dizziness. All of these side-effects require emergency care.
Normally, a person can return to school or the workplace after 24 to 48 hours (as they will no longer be contagious) once antibiotic treatment has started. Antibiotic treatment can help to reduce the duration of the illness by at least a day. If after two days of treatment, there is no symptom improvement, it is best to consult the doctor for a check-up to ensure that there are no further complications.
2. Over-the-counter pain relievers
For relief of accompanying symptoms such as headache and fever, over-the-counter pain relievers may be recommended. A doctor may also recommend an anaesthetic throat spray to alleviate discomfort, tenderness or pain in the throat.
3. Home care
A doctor will likely request an infected person some time at home to rest, especially while still contagious.
Home care recommendations will include:
- Plenty of bed rest to aid the body in fighting infection (this promotes recovery).
- Plenty of warm and soothing liquids such as tea (herbal or liquorice flavour) or lemon water.
- Consuming soothing foods such as soups, broths, cereals, mashed potatoes, yoghurts, soft-cooked eggs, soft fruits, frozen yoghurt and applesauce, which can be easier to swallow.
- Avoiding spicy or acidic foods and beverages, and caffeine drinks.
- Getting plenty of cold liquids, especially water (this can numb the throat a little and provide some relief, aid easier swallowing, as well as prevent dehydration).
- Using an antibacterial gargle or making a salt water gargling mixture to use at home (not to be swallowed).
- Sucking on throat lozenges (antibacterial). *not normally recommended for young children
- Using a cool-mist humidifier.
- Avoiding irritants such as cigarette smoke, fumes and cleaning products.
During the initial 24-hour period of antibiotic treatment a person can take precautions to avoid spreading infection in the following ways:
- Frequent hand washing with warm water and soap
- Covering the nose and mouth when coughing or sneezing, especially when around others
- Using a new toothbrush during initial treatment and replacing it with another once well and the infection has completely cleared (bacteria can collect in toothbrush bristles and potentially re-infect a person)
- Use tissues that can be thrown away (not reusable cloths and handkerchiefs)
A surgical procedure may be considered if strep infections continually recur (multiple times in a year), and a person has not had their tonsils removed (tonsillectomy) or is not responding well to antibiotic treatment. Surgery risks versus benefits will be assessed by the attending doctor. If complications of strep throat are of particular concern and infections continuously recur, surgery may be considered the best means of treatment.
Is a follow-up doctor’s visit necessary?
If symptoms do not improve when expected or new symptoms develop, a consultation with a doctor (either in their consulting rooms or an emergency room at a hospital where necessary) is needed.
Severe reactions to antibiotics such as those of an allergy, must be promptly attended to and the medication discontinued immediately.
Antibiotic resistance occurs in a small number of cases. In this instance, another antibiotic may be prescribed for treatment of an infection.