Strep is a type of bacteria that causes about 20% of sore throats in children. MOST sore throats are not Strep, but rather viruses that will resolve without treatment. Despite the fact that it’s bacterial, Strep will get better by itself without antibiotic treatment! Antibiotics if started early make it go away a little bit faster, perhaps in 4 days instead of 5. The real reason we treat Strep is not to make it go away, but to prevent later complications such as Rheumatic Fever. Antibiotics prevent this as long as they are started within 2 weeks of the onset of symptoms (and even if the child feels better before they are started).
Parents often think their child has Strep because of white patches on the tonsils. Unfortunately, tonsil appearance (size, white patches, swollen glands) are not perfect predictors of Strep infection.
STREP THROAT IS NOT AN EMERGENCY. As long as examination, testing, and treatment are started within 2 weeks, your child will get better. If a provider determines that it is necessary to test for Strep based on exam or history, we will do a ‘rapid Strep test’. If the rapid test is positive, we will treat immediately. If it is negative, we will send a throat culture to the lab. Rapid tests miss about 5% of cases, the confirmatory culture is 100% and results are back in 48-72hours. There is no need to take antibiotics if the tests are negative. We call to confirm positive tests but will not call with negative results.
Sore throats should be cared for with Acetaminophen or Ibuprofen, a bland diet, and plenty of liquids (milk, soup, or ice cream may be better than juice or soda). For the older child salt-water gargles, and anesthetic sprays, or lozenges (Chloraseptic, Sucrets, and many other brands) may help. Danger signs (rare) with a sore throat include:
marked difficulty swallowing
(with drooling and inability to take even liquid in – not just pain with solid food),
loss of voice
(difference in size between the two sides).
Call immediately should any of these occur or if symptoms persist longer than a week (unusual), with or without treatment.