What are the discharge instructions for a patient diagnosed with strep throat?

Discharge Instructions for Strep Throat

Patients diagnosed with strep throat should complete a full 10-day course of antibiotics, even if symptoms improve, to prevent acute rheumatic fever and ensure complete bacterial eradication. 1

Medication Instructions

Antibiotic Treatment

• Penicillin-based antibiotics are the first-line treatment:
  • Adults: Penicillin V 250 mg three times daily for 10 days
  • Children: Amoxicillin 50 mg/kg once daily (maximum 1000 mg) or 25 mg/kg twice daily (maximum 500 mg per dose) for 10 days 1, 2
• Take antibiotics at the start of a meal to minimize gastrointestinal intolerance 2
• For penicillin-allergic patients:
  • Clindamycin 300-450 mg orally three times daily for 10 days (adults)
  • Azithromycin 12 mg/kg once daily (maximum 500 mg) for 5 days (children) 1

Pain Relief

• Ibuprofen: 400 mg every 6-8 hours (adults); 5-10 mg/kg every 6-8 hours (children)
• Acetaminophen (Paracetamol): 500-1000 mg every 4-6 hours (adults); 10-15 mg/kg every 4-6 hours (children)
• Do not give aspirin to children due to risk of Reye syndrome 1

Infection Control Measures

• Stay home from school/work for at least 24 hours after starting antibiotics 1, 3
  • You remain contagious until you've been on antibiotics for 24 hours
• Wash hands frequently with soap and water
• Do not share utensils, drinks, or personal items
• Cover mouth when coughing or sneezing
• Dispose of used tissues properly 1

Home Care Instructions

• Complete the entire antibiotic course (full 10 days) even if you feel better 1, 2, 4
• Stay hydrated by drinking plenty of fluids
• Use throat lozenges or warm salt water gargles for sore throat relief
• Get plenty of rest to support recovery
• Replace toothbrush after 24-48 hours of antibiotic treatment to prevent reinfection

When to Seek Medical Attention

Return to the healthcare provider if:

• Symptoms do not improve within 48-72 hours of starting antibiotics
• Fever persists beyond 48 hours of treatment
• Difficulty swallowing or breathing develops
• Rash appears after starting antibiotics
• Symptoms worsen or new symptoms develop

Follow-up Instructions

• No routine follow-up is needed if symptoms resolve
• If you experience recurrent strep throat (≥7 episodes in the past year, ≥5 episodes per year for 2 years, or ≥3 episodes per year for 3 years), follow up with your provider to discuss possible tonsillectomy 1

Important Notes

• Shortened antibiotic courses (5-7 days) are being studied but are not currently recommended by guidelines 5, 6
• The standard 10-day course is crucial to prevent complications like acute rheumatic fever 1, 2, 4
• Most patients become culture-negative within 24 hours of starting antibiotics, but a full 24-hour period is recommended before returning to school/work 3