Strep throat treatment: What are the options?

Strep throat accounts for about 5% to 15% of cases of sore throat in adults and 15% to 35% of cases in children each year. Although the condition is highly contagious and can lead to serious complications, treatment with appropriate strep throat medication allows most people to make a full recovery quickly.

Caused by group A Streptococcus, strep throat is an infection in the tonsils and roof of the mouth. It is contagious and can spread through close contact. The most common symptom of the infection is a sore throat (pharyngitis), but you may experience additional symptoms, such as:

• Fever
• Fatigue
• Abdominal pain
• Vomiting and nausea
• Loss of appetite
• Swelling of lymph nodes of the neck
• Swollen and red tonsils
• Tiny red spots on the roof of mouth
  
• White patches, spots or pus on the throat and tonsils

Because some symptoms of strep throat can be similar to those of other illnesses, such as the common cold and the flu, a proper diagnosis is necessary.

Your healthcare provider will check your throat and neck to diagnose strep throat. If your throat is very red with spots, your lymph nodes are swollen and tender, and you do not have a runny nose or cough, your provider may strongly suspect strep throat. They may prescribe antibiotics. If there is any question about the accuracy of the diagnosis, a strep test may be done in the office.

To perform the test, your healthcare provider will wipe the back of your throat with a long cotton swab. Rapid strep tests can provide results within 20 minutes, but your healthcare provider may opt to send the sample to a laboratory for further testing. In this case, you will usually receive results in one to three days.

Because strep throat is caused by bacteria, antibiotics are the standard treatment. Some antibiotics commonly prescribed for strep throat include:

• Amoxicillin or penicillin
• Augmentin (amoxicillin and clavulanate)
• Azithromycin
• Cephalexin, also known as the brand name Keflex
• Clindamycin
• Doxycycline

Your healthcare provider will take your symptoms, health history and other factors into consideration when choosing which antibiotic to prescribe. In addition to antibiotics, your healthcare provider may advise you to take acetaminophen (Tylenol), ibuprofen (Advil), or other pain-relieving medication while you wait for the antibiotics to begin working. Drinking plenty of fluids, gargling with warm salt water, and taking honey may also help to alleviate discomfort. Honey should not be given to children less than a year old. Speak to your healthcare provider before giving children any OTC medications or products for symptom relief.

Symptoms of strep throat usually begin to resolve within 24 to 48 hours of starting medication. However, you should take the full course of antibiotics prescribed by your healthcare provider, even if you begin to feel better sooner. Strep throat is typically fully cured within 10 days when antibiotics are taken as directed.

In most cases, strep throat will not resolve on its own, and if untreated, it can lead to serious complications in the heart. There are many articles on how to get rid of strep throat that recommend home remedies for the infection. Still, there is no evidence that any alternative intervention can prevent the complications of strep throat. If left untreated, strep throat may spread to others, and it can lead to serious life-threatening health conditions, such as poststreptococcal glomerulonephritis (inflammation of the kidneys). Rheumatic fever is also caused by untreated strep throat, and it can permanently damage the heart valves. This illness was once common in the United States and even now, it occurs in children and adults in many areas of the world where communities don’t have access to antibiotics.

Once you begin taking antibiotics, you’ll typically continue to be contagious for 24 to 48 hours. Your healthcare provider can give you advice on when you can return to work or when your child can resume going to school.

Published September 2024.