From the Guidelines
Patient education for strep tonsillitis should prioritize informing patients to take the full course of prescribed antibiotics, typically penicillin or azithromycin, and to practice good hygiene to prevent transmission to others. When it comes to patient education, it's essential to recognize the responsibility of the physician to educate the patient and the family, as emphasized by the American Academy of Family Physicians 1. The education should be tailored to the patient's level of readiness, past experience, culture, and understanding, creating an environment conducive to learning with trust, respect, and acceptance 1.
For strep tonsillitis, specifically, the most recent and highest quality study from the Infectious Diseases Society of America (2012) provides guidelines for the diagnosis and management of Group A streptococcal pharyngitis 1. According to these guidelines, antibiotic treatment is crucial to prevent complications such as acute rheumatic fever, and the recommended duration of treatment is typically 10 days. The choice of antibiotic depends on the patient's allergy status, with penicillin being the first-line treatment for those without allergies, and alternatives such as cephalexin, clindamycin, or azithromycin for those with penicillin allergies 1.
In addition to antibiotic treatment, patient education should include instructions on symptom management, such as resting the voice and body, staying hydrated with warm liquids, and using over-the-counter pain relievers like acetaminophen or ibuprofen to manage throat pain and fever. Gargling with warm salt water and using throat lozenges can also provide temporary relief. It's essential to inform patients that they are typically contagious until they've been on antibiotics for 24 hours and should stay home during this period to prevent transmission to others. Practicing good hygiene, such as handwashing and not sharing personal items, is also crucial in preventing the spread of Group A Streptococcus bacteria.
Overall, effective patient education for strep tonsillitis requires a comprehensive approach that includes antibiotic treatment, symptom management, and prevention of transmission, all of which are supported by the latest clinical practice guidelines and evidence-based recommendations 1.
From the FDA Drug Label
Patients should be counseled that antibacterial drugs, including Penicillin V Potassium Tablets and Penicillin V Potassium for Oral Solution should only be used to treat bacterial infections. In streptococcal infections, therapy must be sufficient to eliminate the organism (ten-day minimum): otherwise the sequelae of streptococcal disease may occur. Cultures should be taken following completion of treatment to determine whether streptococci have been eradicated.
The patient education for strep tonsillitis includes:
- Informing patients that antibacterial drugs should only be used to treat bacterial infections
- Ensuring patients understand the importance of completing the full course of therapy to eliminate the organism and prevent sequelae of streptococcal disease
- Advising patients that diarrhea is a common problem caused by antibiotics and may occur even after discontinuation of the antibiotic
- Instructing patients to contact their physician if they experience watery and bloody stools, stomach cramps, and fever after taking the antibiotic 2
- The recommended dose of azithromycin for children with pharyngitis/tonsillitis is 12 mg/kg once daily for 5 days 3