Clinical Reference Systems: Pediatric Advisor 10.0
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DESCRIPTION (Diagnosis must be confirmed by a physician.)

Your child has a strep throat infection. It has been diagnosed with a throat culture or rapid strep test.

The treatment of strep throat can prevent some rare but serious complications: namely, rheumatic fever (a disease that affects the heart) or glomerulonephritis (a disease that affects the kidneys). In addition, with treatment the fever and much of the sore throat are usually gone within 24 hours.

HOME TREATMENT

1. Antibiotics

   Your child needs the antibiotic prescribed by your physician.

   Try not to forget any of the doses. If your child goes to school or a baby sitter, arrange for someone to give the midafternoon dose. If the medicine is a liquid, store the antibiotic in the refrigerator and use a measuring spoon to be sure that you give the right amount. Your child should take the medicine until all the pills are gone or the bottle is empty. Even though your child will feel better in a few days, give the antibiotic for 10 days to keep the strep throat from flaring up again.

   A long-acting penicillin (Bicillin) injection can be given if your child will not take oral medicines or if it will be impossible for you to give the medicine regularly. (Note: If given correctly, the oral antibiotic works just as rapidly and effectively as a shot.)

2. Fever and pain relief

   Children over age 1 can sip warm chicken broth or apple juice. Children over age 4 can suck on hard candy (butterscotch seems to be a soothing flavor) or lollipops. Give your child acetaminophen or ibuprofen for throat pain or fever over 102 degrees F (38.9 degrees C).

3. Diet

   Swollen tonsils can make some foods hard to swallow. Provide your child with a diet of soft foods for a few days if he prefers it.

4. Contagiousness

   Your child is no longer contagious after he has taken the antibiotic for 24 hours. Therefore, your child can return to school after one day if he is feeling better and the fever is gone.

5. Throat cultures for the family

   Strep throat can spread to others in the family. Any child or adult who lives in your home and has a fever, sore throat, runny nose, headache, vomiting, or sores; doesn't want to eat; or develops these symptoms in the next 5 days should be brought in for a throat culture. In most homes only the people who are sick need throat cultures. (In families where relatives have had rheumatic fever or frequent strep infections, everyone should have a throat culture.) Your physician will call you if any of the cultures are positive for strep.

6. Recurrent strep throat and recultures

   Usually repeat throat cultures are not necessary if your child takes all of the antibiotic. However, about 10 percent of children with strep throat don't respond to initial antibiotic treatment. Therefore, if your child continues to have a sore throat or mild fever after treatment is completed, return for a second throat culture. If it is positive, your child will be retreated with a different antibiotic.

CALL YOUR CHILD'S PHYSICIAN IMMEDIATELY IF:

• Your child starts drooling or has great difficulty swallowing.
• Your child is acting very sick.

CALL YOUR CHILD'S PHYSICIAN DURING OFFICE HOURS IF:

• The fever lasts over 48 hours after your child starts taking an antibiotic.
• You have other questions or concerns.