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

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Strep Throat Discharge Instructions

Complete the full 10-day course of antibiotics even if you feel better after a few days, as stopping early increases the risk of treatment failure and rheumatic fever. 1, 2

Antibiotic Treatment

If You Were Prescribed Penicillin or Amoxicillin

  • Take penicillin V 500 mg twice daily OR 250 mg three to four times daily for the full 10 days 1, 3
  • Alternatively, amoxicillin 500 mg twice daily for 10 days is equally effective 1, 3
  • Take your medication at the start of a meal to minimize stomach upset 2
  • Never stop antibiotics early—the full 10-day course is essential to prevent rheumatic fever and ensure bacterial eradication 1, 4

If You Have Penicillin Allergy

  • For non-severe allergies: Take cephalexin (first-generation cephalosporin) for 10 days 1, 3
  • For severe/anaphylactic allergies: Take clindamycin 300 mg three times daily for 10 days OR azithromycin 500 mg once daily for 5 days 1, 3
  • Do not take cephalosporins if you have had an anaphylactic reaction to penicillin 3

When You Can Return to Work/School

Stay home for the first 24 hours after starting antibiotics to prevent spreading the infection to others. 5 After completing 24 hours of antibiotic therapy, you may return to work, school, or daycare even if you still have mild symptoms 5.

Symptom Management

Pain and Fever Relief

  • Take ibuprofen or acetaminophen for throat pain and fever control 1, 3
  • These medications work for moderate to severe symptoms regardless of antibiotic use 1
  • Do not give aspirin to children or adolescents due to the risk of Reye syndrome 1, 4

Additional Comfort Measures

  • Warm salt water gargles may provide temporary throat relief 6
  • Stay well-hydrated with fluids

What to Expect

  • Fever and symptoms typically improve within 24-48 hours of starting antibiotics 1
  • Even without antibiotics, strep throat is self-limited and symptoms usually resolve within 3-4 days, but antibiotics prevent serious complications 1
  • If symptoms worsen after starting antibiotics or persist beyond 5 days of treatment, contact your healthcare provider immediately 7

Household Contacts

Family members who live with you do not need testing or treatment unless they develop symptoms of sore throat. 1 Asymptomatic household contacts should not be tested or treated routinely, as up to 25% may carry the bacteria without being sick 1.

Critical Warnings

Do Not Stop Antibiotics Early

  • Completing less than 10 days of penicillin or amoxicillin increases your risk of treatment failure 1, 4, 8
  • The full course prevents acute rheumatic fever, a serious complication that can damage your heart 1, 2
  • Even if you feel completely better after 3-4 days, continue taking all prescribed medication 1

When to Seek Immediate Care

  • Difficulty breathing or swallowing 7
  • Drooling or inability to swallow saliva
  • Severe worsening of throat pain after starting antibiotics 7
  • Development of a rash
  • High fever that persists beyond 48 hours of antibiotic treatment

Follow-Up

  • You do not need a follow-up throat culture or test after completing treatment unless symptoms return 1, 4
  • If you develop another episode of sore throat within a few weeks, contact your healthcare provider for re-evaluation 1

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Guideline

Acute Pharyngitis Treatment Guidelines

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

Treatment of Streptococcal Pharyngitis

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

Treatment of Group A Streptococcal Infection in Adults

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2026

Research

Streptococcal Pharyngitis: Rapid Evidence Review.

American family physician, 2024

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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