Strep Throat Treatment
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Guide for
Strep Throat Treatment
By Medical Editor:
Dr. Francesco-Maria Serino, MD, PhD
August, 2024
Summary
A strep throat infection is caused by Group A Streptococcus. Common symptoms are a painful throat, fever, swollen neck glands, and sometimes white spots on the tonsils. Antibiotics are needed to treat it. Doctors may check your symptoms and use tests like a throat swab to figure out if it’s viral or bacterial. Severe cases may need extra care from a doctor.
What is strep throat ?
Strep throat is a bacterial infection that causes a sore throat. It’s caused by a type of bacteria called Group A Streptococcus (GAS). Strep throat is most common in children and teenagers, but it can affect adults of all ages.
The infection leads to symptoms like a sudden, painful sore throat, fever, and swollen, tender lymph nodes in the neck. Sometimes, it can also cause red and swollen tonsils, often with white patches or streaks of pus. It’s important to treat strep throat with antibiotics to prevent complications.
What does strep throat look like
This picture comes from a 21 year old patient with significant throat pain, difficulty swallowing and fever.
- Enlarged, Red Tonsils: The tonsils look swollen and have a noticeable red color, which is a common sign of strep throat.
- White Patches or Pus on Tonsils: There are visible white spots or exudates on the tonsils, indicating the presence of pus. This is characteristic of exudative tonsillopharyngitis, often seen in strep throat.
- Inflamed Uvula: The uvula, which is the small piece of tissue hanging down at the back of the throat, appears red and possibly swollen.
How do you get strep throat ?
Strep throat is spread through close contact with an infected person. You can get it by breathing in respiratory droplets, tiny droplets of liquid that come out of your mouth and nose when you talk, cough, sneeze, or breathe, that contain the bacteria. You can also get it by touching surfaces or objects that have the bacteria on them and then touching your mouth, nose, or eyes. Sharing food, drinks, or utensils with an infected person can also spread the bacteria.
Is strep throat contagious ?
Yes, strep throat is highly contagious. It can easily spread from person to person through respiratory droplets when an infected person coughs, sneezes, or talks. It can also spread by touching contaminated surfaces and then touching your face. Because it’s so contagious, it’s important to practice good hygiene, like washing your hands often and avoiding close contact with someone who has strep throat
Strep throat bacteria
The bacteria that cause strep throat are called *Group A Streptococcus* (GAS). This type of bacteria is responsible for the infection and can lead to symptoms like a sore throat, fever, and swollen lymph nodes. In addition to strep throat, GAS can cause other illnesses, but strep throat is one of the most common conditions linked to this bacteria.
Sore throat not due to strep infection
A sore throat that is not caused by strep is usually due to a viral infection. Common viruses like those that cause colds, the flu, or even COVID-19 can lead to a sore throat. These viral infections often come with other symptoms such as a runny nose, cough, and congestion. Unlike strep throat, viral sore throats typically don’t require antibiotics and usually resolve on their own with rest and home care.
Strep throat symptoms
Strep throat often starts suddenly with a very sore throat.
You might also get a fever, headache, and notice your tonsils look red and swollen, sometimes with white spots or patches of pus.
The glands in your neck might feel swollen and tender, and it can hurt to swallow. Some people with strep throat might also get a red rash or feel pain in their ears. Unlike a cold, strep throat usually doesn’t cause a cough.
Symptoms of strep throat can include:
- Sudden onset of sore throat: This is often the first noticeable symptom.
- Fever: A high temperature usually accompanies strep throat.
- Red and swollen tonsils: Sometimes with white spots or streaks of pus (strep throat white spots).
- Tender, swollen lymph nodes: Particularly in the neck.
- Headache: Commonly occurs with strep throat.
- Rash: Known as a scarlatiniform rash, a red rash that feels rough, like sandpaper and can develop in some cases (strep throat rash).
- Pain when swallowing: This is another key sign of strep throat.
- Absence of cough: Unlike viral infections, strep throat typically does not cause a cough.
- Ear pain: Some people may experience pain that seems to come from the ears (strep throat ear pain).
Strep throat vs sore throat
Strep throat often starts suddenly with a very sore throat.
You might also get a fever, headache, and notice your tonsils look red and swollen, sometimes with white spots or patches of pus.
The glands in your neck might feel swollen and tender, and it can hurt to swallow. Some people with strep throat might also get a red rash or feel pain in their ears. Unlike a cold-associated cough, strep throat usually doesn’t cause a cough.
Strep throat and Covid
Strep throat and COVID-19 can both cause a sore throat, but there are key differences:
Strep Throat:
– Sudden onset of a very sore throat.
– No cough or runny nose.
– Red and swollen tonsils, sometimes with white spots.
– Fever, headache, and swollen glands in the neck.
– Caused by bacteria, and treated with antibiotics.
COVID-19:
– Sore throat can occur, but it’s often accompanied by other symptoms like cough, shortness of breath, loss of taste or smell, and body aches.
– Fever may be present but can be lower grade.
– Fatigue, nasal congestion, and other upper respiratory symptoms are common.
– Caused by a virus (SARS-CoV-2), so antibiotics are not effective.
Testing is the best way to distinguish between the two since they share overlapping symptoms.
Mono throat vs strep throat
Strep throat and mononucleosis (often called “mono”) can both cause sore throats, but they have key differences:
– Cause:
- Strep Throat: This is caused by bacteria called Group A Streptococcus.
- Mono: This is caused by a virus, usually the Epstein-Barr virus (EBV).
– Symptoms:
- Strep Throat: Symptoms come on quickly. You may have a very sore throat, fever, red and swollen tonsils, sometimes with white spots, headache, and swollen glands in your neck. Strep throat usually doesn’t cause tiredness or an enlarged spleen.
- Mono: Symptoms develop slowly and often include a severe sore throat, extreme tiredness, swollen lymph nodes, fever, and sometimes an enlarged spleen or liver. Mono can also cause a skin rash and symptoms that last longer.
– Diagnosis:
- Strep Throat: Diagnosed with a rapid strep test or a throat culture, where a swab is taken from your throat.
- Mono: Diagnosed with blood tests that check for antibodies against the Epstein-Barr virus.
– Treatment:
- Strep Throat: Treated with antibiotics to kill the bacteria.
- Mono: No specific treatment but about 90% of patients with mono who take amoxicillin by mistake develop a widespread, non-itchy, rash . Care focuses on easing symptoms and letting your body heal naturally.
These differences help doctors decide which tests to perform and how to treat the symptoms.
Strep throat symptoms in kids
Strep throat in children can vary depending on their age.
For Children 3 Years and Older:
- Sudden Symptoms: Strep throat often starts quickly, with little warning.
- Fever: A common sign, the child may feel hot and uncomfortable.
- Headache: Often occurs along with the sore throat.
- Stomach Pain, Nausea, and Vomiting: These symptoms can cause a child to eat less.
- Sore Throat: The throat usually feels very painful, making swallowing hard.
- Swollen Tonsils with White Patches: The tonsils, which are the two lumps at the back of the throat, may become red and swollen, sometimes with white spots or pus.
- Swollen Neck Lymph Nodes: The glands in the neck, which help fight infections, may become tender and swollen.
- Red Spots on the Roof of the Mouth: Small red dots may appear on the soft part of the roof of the mouth.
- Swollen Uvula: The uvula, the small piece of tissue that hangs down at the back of the throat, may be red and swollen.
- Rash: A red, sandpaper-like rash may start in areas like the groin or armpits and spread to other parts of the body.
For Children Under 3 Years:
- Runny or Stuffy Nose: Younger children often have more nasal symptoms.
- Mild Fever: The fever is usually low, under 38.3°C (101°F).
- Swollen Neck Glands: The glands in the neck may be tender but usually less so than in older children.
- General Discomfort: Babies may be fussy, eat less, and generally seem unwell.
These symptoms can help identify strep throat, but not all children will show every sign.
How to know if you have strep
To know if you have strep throat, look for these key signs:
- Sudden, severe sore throat without a cough.
- Fever and chills.
- Red and swollen tonsils, sometimes with white spots or streaks of pus.
- Swollen, tender lymph nodes in your neck.
- Headache and pain when swallowing.
If you have these symptoms, especially without cold-like symptoms such as a runny nose or cough, it’s a good idea to talk to a doctor.
Strep test
Clinical evaluation alone is sometimes not enough to diagnose strep throat accurately. The symptoms of strep throat can be sometimes very similar to those caused by viral infections, so a lab test like a rapid strep test or throat culture is needed to confirm the diagnosis. Doctors often use clinical signs to decide whether to test for strep throat, but they rely on test results to make a definitive diagnosis.
To test for strep throat, doctors usually use a “rapid strep test” or RADT. Here’s how it works:
- Throat Swab: A doctor swabs the back of your throat to collect a sample.
- Rapid Test: The sample is tested immediately using a special kit. Results are ready in about 10-15 minutes.
- Accuracy: The rapid test is very specific, meaning if it shows you have strep, it’s almost always correct. However, it can sometimes miss an infection (false negative).
If the rapid test is negative but the doctor still suspects strep, they might send the sample for a throat culture, which is more accurate but takes longer (3-4 days) to get results.
Strep throat treatment
The treatment for strep throat involves antibiotics, which help clear the infection and prevent complications.
Antibiotics for strep throat
Penicillin or amoxicillin is commonly prescribed. If you’re allergic to these, other antibiotics like azithromycin may be used. Symptoms usually improve within a few days of starting antibiotics, but it’s important to finish the full course to ensure the infection is completely eliminated.
Strep throat treatment without antibiotics
Strep throat is best treated with antibiotics because they help to clear the infection, reduce symptoms, and prevent complications like rheumatic fever. Without antibiotics, strep throat can eventually go away on its own, but it might take longer to recover, and the risk of complications significantly increases. Antibiotics also help reduce the contagious period, so you don’t spread the infection to others. It’s important to follow a doctor’s advice and take the prescribed antibiotics if strep throat is diagnosed.
Strep throat self-care
In addition to antibiotics, supportive care can help ease symptoms.
For self-care during strep throat, you can:
- Get plenty of rest to help your body fight the infection.
- Drink lots of fluids like water, herbal teas, and broths to keep your throat moist and prevent dehydration.
- Take over-the-counter pain relievers like ibuprofen or acetaminophen to reduce pain and fever.
- Gargle with warm salt water to soothe your sore throat.
- Eat soft foods that are easy to swallow, such as soups, mashed potatoes, and yogurt.
- Use a humidifier to keep the air moist, which can help soothe a dry, sore throat.
These steps can help you feel better while the antibiotics work to clear the infection.
Common strep throat medications
Amoxicillin
tablets
Azithromycin
tablets
Untreated strep throat
If strep throat isn’t treated, it can lead to some serious health problems. Here’s what could happen:
- Rheumatic fever: This is a disease that can cause inflammation in different parts of your body, including your heart, joints, skin, and brain. It might show up a few weeks after having strep throat and could even lead to lasting heart damage.
- Kidney problems: After strep throat, some people can develop a condition called Post-streptococcal glomerulonephritis where their kidneys get inflamed. This can cause symptoms like blood in your urine, swelling, and high blood pressure.
- Tonsil abscess: If the infection gets worse, it can cause a pocket of pus to form near your tonsils (peritonsillar abscess). This is very painful, can make it hard to swallow, and might need to be drained by a doctor.
- Infection spreading: The bacteria from strep throat can move to other parts of your body, leading to issues like sinus infections, ear infections, or even more severe illnesses like meningitis or pneumonia.
How long does strep throat last ?
Strep throat typically lasts about 3 to 7 days. If you start antibiotics, you should begin to feel better within a day or two, but it’s crucial to complete the entire course of medication to fully clear the zinfection.
Without antibiotics symptoms might slowly get better on their own, but the infection can linger longer than it would with treatment. Not taking antibiotics also significantly increases the risk of complications, like rheumatic fever or kidney problems, which can develop after the initial sore throat goes away. Antibiotics help prevent these serious problems, which is why it’s important to treat strep throat properly.
Strep throat still hurts after antibiotics
If your strep throat still hurts after starting antibiotics, it could be because the infection hasn’t fully cleared. Antibiotics usually start working within a day or two, but if the pain continues, here are some possible reasons:
- Treatment isn’t finished: The antibiotics might need more time to fully clear the infection, or you haven’t finished the full course yet.
- Complications: There could be another problem, like a pus-filled area near the tonsils, that is causing ongoing pain.
- Other causes: Another condition might be present along with strep throat, leading to continued symptoms.
If your throat still hurts after finishing the antibiotics, or if the pain is severe or getting worse, you should see a doctor for further evaluation.
References
- Muthanna, A., N. H. Shamsuddin, A. Abdul Rashid, et al. “Diagnostic Accuracy of Centor Score for Diagnosis of Group A Streptococcal Pharyngitis among Adults in Primary Care Clinics in Malaysia.” Malaysian Journal of Medical Sciences 29 (2022): 88.
- André, M., I. Odenholt, A. Schwan, et al. “Upper Respiratory Tract Infections in General Practice: Diagnosis, Antibiotic Prescribing, Duration of Symptoms and Use of Diagnostic Tests.” Scandinavian Journal of Infectious Diseases 34 (2002): 880.
- Brook, Itzhak. “The Role of Beta-Lactamase-Producing Bacteria in Mixed Infections.” Pediatric Infectious Disease Journal 18, no. 8 (1999): 731-732.
- Breese, B. B. “A Simple Scorecard for the Tentative Diagnosis of Streptococcal Pharyngitis.” American Journal of Diseases of Children 120, no. 6 (1970): 497-500.
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How does it work?
99% of our users solve their issue within 1 hour. No waiting, no language barriers, no insurance needed.
Answer a few questions
Just answer a few questions about your strep throat symptoms and choose a convenient time for your online session. It’s simple and hassle-free, with no need to sign up.
Select and connect
Doctors respond in minutes. Select your preferred one and start your virtual consultation right from your web browser.
7-day free follow-up chat
Reach out to your doctor with any questions you might have, at no extra cost for 7 days following your consultation.
Your questions answered
How is strep throat spread ?
Strep throat is spread through close contact with an infected person. You can catch it by breathing in droplets when someone with strep throat coughs, sneezes, or talks. Touching surfaces or objects contaminated with these droplets and then touching your mouth, nose, or eyes can also spread the bacteria.
How to know if you have strep throat ?
You might have strep throat if you suddenly develop a very sore throat, fever, red and swollen tonsils with white spots, and swollen, tender lymph nodes in your neck. Strep throat usually doesn’t come with a cough, which can help distinguish it from other causes of sore throat.
How to get rid of strep throat overnight ?
Unfortunately, you can’t get rid of strep throat overnight. Antibiotics are needed to treat the infection, and symptoms usually improve within 1 to 2 days after starting treatment. Rest, fluids, and over-the-counter pain relievers can help ease symptoms.
Can you get strep throat without tonsils ?
Yes, you can get strep throat even if you don’t have tonsils. The bacteria infect the throat and can cause similar symptoms even in people who have had their tonsils removed.
Does strep throat go away on its own ?
Strep throat can go away on its own, but it may take longer, and there is a higher risk of serious complications like rheumatic fever. Antibiotics help to clear the infection faster and prevent these complications.
Can you fully recover from strep throat without antibiotics ?
You might recover from strep throat without antibiotics, but the risk of complications is higher. Antibiotics are recommended to ensure full recovery and to prevent problems like heart and kidney issues.
How long is strep contagious ?
Strep throat is contagious for about 24 hours after starting antibiotics. Without treatment, you can remain contagious for up to two to three weeks.
Can you have strep throat without a fever ?
Yes, it is possible to have strep throat without a fever. Other symptoms like a sore throat, swollen glands, and white spots on the tonsils can still indicate strep throat even if you don’t have a fever.
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