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Strep throat - Treatment

Alternative Names

Pharyngitis - streptococcal; Streptococcal pharyngitis

Treatment:

Be aware that most sore throats are caused by viruses, not strep. Sore throats should only be treated with antibiotics if the strep test is positive. Strep cannot be accurately diagnosed by symptoms or a physical exam alone.

Even though strep throat usually gets better on its own, antibiotics are taken to prevent rare but more serious complications, such as rheumatic fever. Penicillin or amoxicillin has been traditionally recommended and is still very effective. There has been resistance reported to azithromycin and related antibiotics.

Most sore throats are soon over. In the meantime, the following remedies may help:

Drink warm liquids. Honey or lemon tea is a time-tested remedy.
Gargle several times a day with warm salt water (1/2 tsp of salt in 1 cup water).
Drink cold liquids or suck on popsicles to soothe the sore throat.
Suck on hard candies or throat lozenges. This is often as effective as more expensive remedies, but should not be used in young children because of the choking risk.
Use a cool-mist vaporizer or humidifier to moisten and soothe a dry and painful throat.
Try over-the-counter pain medications, such as acetaminophen. Do NOT give aspirin to children.

Expectations (prognosis):

The probable outcome is good. Nearly all symptoms resolve in one week. Treatment prevents serious complications associated with streptococcal infections.

Complications:

Calling your health care provider:

Call if you develop the symptoms of strep throat, whether or not you think you were exposed to someone with strep throat. Also, call if you are being treated for strep throat and are not feeling better within 24 - 48 hours.

Throat anatomy

Strep throat

Reviewed last on: 3/14/2009
Linda Vorvick, MD, Family Physician, Seattle Site Coordinator, Lecturer, Pathophysiology, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; and Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Alcaide ML, Bisno AL. Pharyngitis and epiglottitis. Infect Dis Clin North Am. 2007;21:449-469.

Del Mar C, Glasziou PP, Spinks A. Antibiotics for sore throat. Cochrane Database Syst Rev. 2006 Oct 18;(4):CD000023.

Institute for Clinical Systems Improvement. Health care guideline: Diagnosis and treatment of respiratory illness in children and adults. February 2008. Acessed November 9, 2008.

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