Clinical Reference Systems: Pediatric Advisor 10.0

DESCRIPTION (Diagnosis must be confirmed by a physician.)

You have 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

   You need the antibiotic prescribed by your physician.

   Take the medicine until all the pills are gone. Even though you will feel better in a few days, take the antibiotic for 10 days to keep the strep throat from flaring up again.

   A long-acting penicillin (Bicillin) injection can be given if it will be impossible for you to take the oral antibiotic regularly. (Note: If taken correctly, the oral antibiotic works just as rapidly and effectively as a shot.)

2. Fever and pain relief

   Gargle warm saltwater (1/4 teaspoon of salt per glass) or an antacid solution. You can suck on hard candy (butterscotch seems to be a soothing flavor). Take acetaminophen or ibuprofen for throat pain or fever over 102 degrees F (39 degrees C).

3. Diet

   Swollen tonsils can make some foods hard to swallow. Eat a diet of soft foods for a few days.

4. Contagiousness

   You are no longer contagious after you have taken the antibiotic for 24 hours. Therefore, you can return to school after one day if you are 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, 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 cultures are not necessary if you take all of the antibiotic. However, about 10% of people with strep throat don't respond to initial antibiotic treatment. Therefore, if you continue to have a sore throat or mild fever after treatment is completed, return for a second throat culture. If it is positive, you will be retreated with a different antibiotic.

CALL YOUR PHYSICIAN IMMEDIATELY IF:

• You have great difficulty swallowing (for example, you can't swallow your saliva).
• You are feeling very sick.

CALL YOUR PHYSICIAN DURING OFFICE HOURS IF:

• The fever lasts over 48 hours after you start taking an antibiotic.
• You have other questions or concerns.