From the Guidelines
If you've been in contact with someone who has strep throat, you should monitor yourself for symptoms such as sore throat, fever, headache, and swollen lymph nodes for about 2-5 days, which is the typical incubation period, and only seek medical attention if symptoms develop, at which point a rapid strep test or throat culture can confirm the infection and guide treatment with antibiotics, such as penicillin V or amoxicillin, for 10 days, as recommended by the Infectious Diseases Society of America 1.
Key Considerations
- The majority of pharyngitis cases are caused by viruses, and antibiotics are only beneficial for group A streptococcal infections, which can be confirmed with a rapid strep test or throat culture 1.
- Antibiotics, such as penicillin V (250-500 mg orally 2-3 times daily for 10 days) or amoxicillin (500 mg twice daily for 10 days), are the standard treatment for strep throat, with alternatives like azithromycin or clindamycin available for those with penicillin allergies 1.
- Completing the full course of antibiotics is crucial, even if symptoms improve sooner, to ensure the infection is fully eradicated and reduce the risk of complications, such as acute rheumatic fever or peritonsillar abscess 1.
- While waiting for medical care, symptoms can be managed with over-the-counter pain relievers, warm salt water gargles, and plenty of fluids, and good hand hygiene and avoiding sharing personal items can help prevent transmission to others 1.
Prevention and Transmission
- Strep throat is most contagious during active infection and before antibiotic treatment, emphasizing the importance of good hand hygiene and avoiding close contact with others to prevent transmission 1.
- Routine testing for other bacterial causes of pharyngitis, such as Fusobacterium necrophorum, is not recommended, but clinicians should remain vigilant for severe pharyngitis and suspect Lemierre syndrome in adolescent and young adult patients 1.
From the FDA Drug Label
In streptococcal infections, therapy must be sufficient to eliminate the organism (ten-day minimum): otherwise the sequelae of streptococcal disease may occur.
If somebody has been in contact with strep throat, monitoring for symptoms and testing for the infection should be considered. If the person develops symptoms, antibiotic treatment may be necessary to prevent complications. It is essential to complete the full course of therapy as prescribed by a healthcare professional to ensure the infection is fully treated and to reduce the risk of antibiotic resistance. Preventive measures, such as practicing good hygiene, including frequent handwashing, can help reduce the risk of transmission. 2
From the Research
Steps to Take After Contact with Strep Throat
If somebody has been in contact with strep throat, the following steps can be taken:
- Monitor for symptoms: Common signs and symptoms of streptococcal pharyngitis include sore throat, temperature greater than 100.4 degrees F (38 degrees C), tonsillar exudates, and cervical adenopathy 3.
- Seek medical attention: If symptoms persist or worsen, seek medical attention to determine the best course of action 4.
- Diagnostic tests: Available diagnostic tests include throat culture and rapid antigen detection testing 3.
- Treatment: Penicillin (10 days of oral therapy or one injection of intramuscular benzathine penicillin) is the treatment of choice because of cost, narrow spectrum of activity, and effectiveness 3.
- Alternative treatments: Amoxicillin is equally effective and more palatable, while erythromycin and first-generation cephalosporins are options in patients with penicillin allergy 3.
Prevention of Transmission
To prevent the transmission of strep throat:
- Practice good hygiene: Wash hands frequently and avoid close contact with individuals who have strep throat 5.
- Avoid sharing personal items: Avoid sharing personal items such as utensils, glasses, and towels to prevent the spread of the infection 5.
- Stay home: If diagnosed with strep throat, stay home from work or school to prevent the spread of the infection 4.
Antibiotic Treatment
Antibiotic treatment for strep throat:
- Penicillin is the first-line treatment: Penicillin is the recommended treatment for strep throat due to its effectiveness and narrow spectrum of activity 3, 4.
- Alternative antibiotics: Other antibiotics such as amoxicillin, erythromycin, and first-generation cephalosporins may be used in patients with penicillin allergy 3, 4.
- Duration of treatment: The recommended duration of antibiotic treatment for strep throat is 10 days 4.