Strep throat is a common bacterial infection affecting the throat and tonsils, causing a sore and scratchy sensation. Unlike many viral sore throats, strep throat is caused by specific bacteria, which dictates a different treatment approach.
What is Strep Throat
Strep throat is a bacterial infection caused by Streptococcus pyogenes, also known as Group A Streptococcus (GAS). Unlike viral sore throats, which often include symptoms like coughing, runny nose, and hoarseness, strep throat typically presents with a sudden onset of symptoms.
Common indicators of strep throat include a sudden, severe sore throat, fever, and sometimes white patches or streaks of pus on the tonsils. Individuals might also experience tiny red spots on the roof of the mouth, swollen and tender lymph nodes in the neck, and pain when swallowing. The infection spreads easily through respiratory droplets when an infected person coughs, sneezes, or talks, and can also be transmitted through shared food or drinks.
Why Treating Strep Throat Matters
While some mild cases of strep throat might appear to resolve on their own, medical intervention is important due to the risk of serious complications. The primary reason for antibiotic treatment is to prevent these potential severe complications, rather than solely to alleviate symptoms.
One of the most concerning complications is rheumatic fever, an inflammatory condition that can affect the heart, joints, brain, and skin. Rheumatic fever is not an infection itself, but rather an immune response where the body mistakenly attacks its own tissues after a strep infection. This can result in permanent damage to heart valves, a condition known as rheumatic heart disease, which can lead to congestive heart failure.
Another serious complication is post-streptococcal glomerulonephritis (PSGN), an inflammatory kidney disease. PSGN can develop one to two weeks after an untreated throat infection. While the strep bacteria do not directly infect the kidneys, the immune system’s response can cause inflammation in the kidney’s filtering units, potentially leading to damage. Antibiotic treatment eliminates the bacteria and significantly reduces the likelihood of these severe, long-term problems.
Identifying and Treating Strep Throat
Diagnosing strep throat typically involves a visit to a healthcare provider who will assess symptoms and perform a physical exam. To confirm the presence of Group A Streptococcus bacteria, a rapid antigen detection test (RADT) is often performed. This test involves swabbing the back of the throat and can provide results within minutes. If the rapid test is negative but strep throat is still suspected, especially in children, a throat culture may be done, though results can take up to two days.
Once strep throat is confirmed, antibiotics are prescribed. Penicillin and amoxicillin are commonly chosen due to their effectiveness against Group A Streptococcus and their safety profile. For individuals with penicillin allergies, alternative antibiotics like cephalexin, azithromycin, or clindamycin may be used. It is important to complete the full course of antibiotics, typically 10 days, even if symptoms improve earlier. Stopping treatment prematurely can lead to recurrence of the infection and increase the risk of developing serious complications like rheumatic fever or kidney inflammation.
In addition to antibiotics, supportive care measures can help alleviate symptoms. These include getting plenty of rest, staying hydrated with water and soothing liquids like warm tea, and eating soft foods. Gargling with warm salt water can also help relieve throat pain and reduce swelling. Over-the-counter pain relievers, such as acetaminophen or ibuprofen, can be used to manage fever and throat discomfort. Individuals are usually no longer contagious 24 hours after starting antibiotic treatment and can often return to school or work at that point, provided their fever has subsided.