Strep throat, a bacterial infection caused by Group A Streptococcus (GAS), is a common cause of sore throat. The duration of the illness and the risk of complications are closely tied to the timeliness of antibiotic treatment. Seeking medical care quickly for a proper diagnosis and starting a full course of medication is the most effective way to shorten the infection’s course.
Expected Duration of Symptoms with Treatment
Once a person begins an appropriate antibiotic treatment, the timeline for symptom improvement is generally swift. Most individuals notice a significant reduction in their symptoms within 24 to 48 hours of taking the first dose. The fever typically subsides first, followed by a gradual easing of the severe throat pain and discomfort when swallowing.
The rapid improvement in how a person feels can give the impression that the infection is gone completely. However, the full course of antibiotics, which is usually prescribed for 10 days, must be completed to ensure the bacteria are fully eradicated. Stopping treatment early, even when feeling better, risks the bacteria surviving and multiplying again. This can lead to a return of symptoms and increases the chance of developing more serious health complications. Completing the entire 10-day regimen, even after symptoms have disappeared, is the only way to confirm a full cure and prevent these long-term risks.
Contagion and Clearing the Infection
The period a person remains contagious is greatly reduced by starting antibiotic therapy. A person with strep throat is no longer considered a risk to others approximately 24 hours after initiating treatment. This rapid decrease in the bacterial load makes the individual safe to return to normal activities, such as school or work.
This 24-hour mark is a public health benchmark for limiting the spread of the illness. It is important that this return to activity only occurs if the individual is also fever-free. The swift action of the antibiotics essentially neutralizes the person as a carrier, even if some minor symptoms have not entirely resolved. Conversely, a person with untreated strep throat can remain contagious and capable of spreading the bacteria for up to two or three weeks.
Timelines for Untreated Strep and Potential Complications
If strep throat is left untreated, the immediate symptoms may still resolve on their own after seven to ten days. While the initial discomfort may pass, the greater danger lies in the body’s immune response to the bacteria that remain. The presence of the Group A Streptococcus bacteria can trigger inflammatory and autoimmune reactions that affect other body systems.
One of the most serious delayed complications is acute rheumatic fever, which can manifest two to four weeks after the initial throat infection. This condition involves the body mistakenly attacking its own tissues, potentially causing permanent damage to the heart valves and leading to long-term cardiac problems. Another concern is post-streptococcal glomerulonephritis, an inflammatory condition that can affect the kidneys. This complication often develops one to three weeks after the strep infection.
Local complications can also occur during the active infection, such as the spread of bacteria causing peritonsillar abscesses or ear and sinus infections. Timely antibiotic treatment is not primarily to shorten the duration of symptoms but to prevent the onset of these severe, non-throat-related complications.