From the Guidelines
Strep throat, caused by group A Streptococcus bacteria, primarily causes a severe sore throat, pain when swallowing, fever, red and swollen tonsils often with white patches, tiny red spots on the roof of the mouth, and swollen lymph nodes in the neck, and if left untreated, can lead to serious complications. The effects of Streptococcal (Strep) pharyngitis are significant, and it is essential to diagnose and treat the condition promptly to prevent complications. According to the most recent and highest quality study 1, the diagnosis of GAS pharyngitis should be established through a rapid antigen detection test and/or culture for group A Streptococcus. The treatment typically involves antibiotics, most commonly penicillin (250-500mg orally four times daily for 10 days) or amoxicillin (500mg twice daily for 10 days), as recommended by the Infectious Diseases Society of America 1. For those allergic to penicillin, alternatives include azithromycin (500mg on day 1, then 250mg daily for 4 days) or clindamycin (300mg three times daily for 10 days) 1. Complete antibiotic courses are essential even if symptoms improve, as this prevents complications and reduces contagiousness. Over-the-counter pain relievers like acetaminophen or ibuprofen can help manage throat pain and fever, and rest, increased fluid intake, gargling with salt water, and using throat lozenges can provide additional symptom relief 1. The bacteria spread through respiratory droplets, so avoiding close contact with infected individuals and practicing good hand hygiene helps prevent transmission. It is also important to note that antibiotics are not recommended for chronic group A Streptococcus carriers because they are unlikely to spread infection to close contacts and are at little or no risk for complications 1. In addition, tonsillectomy solely to reduce the frequency of group A streptococcal pharyngitis in adults is not recommended 1. The typical course of a sore throat is less than 1 week, and antibiotics are usually not needed because they do little to alleviate symptoms and may have adverse effects 1.
Some key points to consider:
- The diagnosis of GAS pharyngitis should be established through a rapid antigen detection test and/or culture for group A Streptococcus 1.
- Antibiotics are essential for treating GAS pharyngitis, but should only be prescribed for patients with a positive streptococcal test result 1.
- The treatment typically involves antibiotics, most commonly penicillin or amoxicillin, and complete antibiotic courses are essential even if symptoms improve 1.
- Over-the-counter pain relievers and rest, increased fluid intake, gargling with salt water, and using throat lozenges can provide additional symptom relief 1.
- The bacteria spread through respiratory droplets, so avoiding close contact with infected individuals and practicing good hand hygiene helps prevent transmission.