What are the symptoms and treatment options for streptococcal pharyngitis (strep throat)?

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Last updated: March 28, 2025View editorial policy

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From the Guidelines

Strep throat is a bacterial infection that requires prompt diagnosis and treatment with antibiotics, such as penicillin V or amoxicillin, to prevent complications and reduce symptom duration. The symptoms of strep throat include sore throat, fever, and swollen lymph nodes. If you suspect strep throat, see a healthcare provider for proper diagnosis through a rapid strep test or throat culture.

Treatment Options

  • The standard treatment is antibiotics, typically penicillin V (250-500 mg orally twice daily for 10 days) or amoxicillin (500 mg twice daily for 10 days) 1.
  • For those allergic to penicillin, alternatives include azithromycin (500 mg on day 1, then 250 mg daily for 4 more days) or clindamycin (300 mg three times daily for 10 days) 1.
  • Complete the entire antibiotic course even if symptoms improve to prevent complications like rheumatic fever.

Symptom Relief

  • Take acetaminophen or ibuprofen for pain and fever.
  • Gargle with warm salt water.
  • Use throat lozenges.
  • Drink plenty of fluids.
  • Rest.

Prevention

  • Strep throat is highly contagious, so wash hands frequently.
  • Avoid sharing personal items.
  • Stay home until fever-free for 24 hours and after taking antibiotics for at least 24 hours. Without treatment, strep throat typically resolves in 3-7 days, but antibiotics reduce symptom duration and prevent serious complications 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. Pharyngitis/tonsillitis caused by Streptococcus pyogenes as an alternative to first-line therapy in individuals who cannot use first-line therapy Penicillin by the intramuscular route is the usual drug of choice in the treatment of Streptococcus pyogenes infection and the prophylaxis of rheumatic fever.

The symptoms of streptococcal pharyngitis (strep throat) are not explicitly listed in the provided drug labels. Treatment options for streptococcal pharyngitis include:

  • Penicillin (first-line therapy) 2
  • Azithromycin (as an alternative to first-line therapy in individuals who cannot use first-line therapy) 3, 3

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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