One of the common causes of a sore throat is strep throat. It causes an inflamed, sore throat and tonsils often accompanied by fever and painful swallowing. It is quite contagious and is spread by sharing food and drinks, sneezing, coughing, and touching infected surfaces. Children are more likely to get strep throat than adults, but anyone can become infected with strep throat. Let’s take a look at treatment, medications, and natural remedies to manage strep throat.
Strep throat is a bacterial infection caused by group A Streptococcus or Streptococcus pyogenes. The main symptom of strep throat is a sore throat, also known as pharyngitis. Sore throats are also common in viral infections, such as a cold. However, the sore throat from viral infections usually goes away within two days and other viral symptoms like runny nose, sneezing and coughing begin. Strep throat often does not have these symptoms. Common symptoms of strep throat include:
Sudden onset of throat pain
Fever of 101 F or higher
Red, enlarged tonsils and white patches on the back of the throat
Small red spots on the soft and hard palate
Painful swallowing
Headache
Stomach pain
Loss of appetite
Lethargy
Chills
Tender, swollen lymph nodes
Body aches
Nausea, vomiting
According to the CDC, about 1 in 10 adults with sore throats have strep throat and 3 to 10 children with sore throats typically have strep. Strep throat is most common in the winter and spring. The most common treatment for strep throat is antibiotics. There are medications and home remedies that can help alleviate the symptoms, such as taking ibuprofen to relieve fever and gargling with warm salt water to help ease the pain of the sore throat. There is currently research for a potential vaccine for strep throat, but one is not available at this time.
If you have a sore throat accompanied by fever for more than two days, you should visit a doctor. At your doctor’s visit, you may be asked questions such as:
How long have you had your symptoms?
Have you recently been exposed to strep throat?
Does anything relieve your symptoms?
Do you have any other medical conditions?
During the appointment, your doctor will likely examine you by taking your temperature, feeling your neck for swollen lymph nodes, and visually inspecting your throat. Based on this examination, your doctor may run one of two tests to check for sore throat:
A rapid antigen test or rapid strep test may be administered if strep throat is suspected. During this test, your doctor will swab the back of your throat for a sample. The antigen test can detect strep bacteria within a few minutes, but it is an imperfect test. If the test comes back negative, but your doctor suspects strep, he or she may perform a throat culture.
Throat cultures are done by taking a swab of the back of the throat and then sending it for culture in a laboratory. This test can take up to two days, whereas the rapid antigen test only takes minutes.
Based on the results of the strep test your doctor may write you a prescription for antibiotics. During this appointment, you should ask any questions you may have, including:
What is causing my sore throat?
What tests will be performed today?
What is the treatment? Are there any side effects of this treatment?
How long will the treatment take?
How long before my sore throat is improved?
How long will I be contagious?
How can I prevent strep throat in the future?
If your strep test comes back positive, your healthcare provider will most likely prescribe an antibiotic treatment. Once treatment starts, you should feel improvement within a day or two. It is very important to finish your antibiotics even if you feel better since strep throat can cause serious complications, such as rheumatic fever or glomerulonephritis (kidney inflammation), or into other serious infections within the streptococcal infection group, such as scarlet fever or impetigo. To manage the symptoms of strep throat there are over the counter medications, such as acetaminophen to reduce fever and pain, and at-home remedies like drinking plenty of water.
Antibiotics are usually prescribed to treat the strep throat bacteria to help you feel better faster and to decrease the chances of you getting serious complications. The most commonly prescribed antibiotics are penicillin and amoxicillin. These drugs are safe, typically inexpensive, and are good at killing streptococcal infections in the throat, so they are the first choice for those with strep throat. For those allergic to penicillin—azithromycin, cefixime, clarithromycin, or clindamycin may be prescribed instead. Side effects of antibiotics often include upset stomach, yeast infections, or oral thrush (yeast overgrowth).
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Common side effects of antibiotics are nausea, vomiting, diarrhea, yeast infections, and oral thrush (yeast overgrowth in the mouth). This is not a full list of side effects. You should discuss possible side effects and drug interactions with a healthcare professional such as your doctor.
While there is no known cure for strep throat with home remedies, there are ways to treat the symptoms of sore throat. Some options to help alleviate the symptoms of strep throat at home include:
Drink plenty of warm liquids, such as hot tea, soups or broth. This will alleviate some of the irritation of the sore throat and keep you hydrated. Adding honey, peppermint, licorice root, or ginger to your tea can also help soothe your throat.
Eating something cold, like a popsicle, or sucking on hard candy or lozenge can also help relieve some of the throat soreness.
Gargling with warm salt water may reduce swelling and irritation in the throat. Mix ¼ to ½ teaspoon of salt in 8 oz of warm water and gargle (do not swallow the saltwater). This can be done every hour for relief.
Get plenty of rest to help your body fight the infection.
Avoid acidic foods that may irritate your throat, such as citrus fruits or tomatoes.
Over the counter medications and pain relievers, such as Tylenol, Motrin, Aleve or Advil may be used to help reduce fever and pain associated with strep throat.
Running a humidifier can help keep mucous membranes moist and decrease some of the irritation caused by a strep throat infection.
In some cases, strep throat can go away on its own. However, if strep throat does not go away on its own, it can lead to potentially dangerous\ complications such as scarlet fever or rheumatic fever. Due to this, it is best to treat strep throat with antibiotics, which will give you quicker relief of your symptoms.
Typically it takes 3-7 days to recover from strep throat. However, once antibiotics are started it typically takes 1-2 days to feel relief from symptoms.
The first sign of strep throat is a sudden onset of sore throat, later followed by fever and possible white patches in the back of the throat.
While apple cider vinegar does have some antibacterial properties there is no research that shows its effectiveness in killing strep throat bacteria. Some people claim apple cider vinegar helps soothe sore throats, but data on this is also limited.
Cough is NOT associated with strep throat. A cough accompanied by a sore throat is more closely associated with cold or flu viruses.
Michael L. Davis, MD, is a family medicine specialist in Florida.
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