Flores AR, Caserta MT. Pharyngitis. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 59. Show
Harris AM, Hicks LA, Qaseem A; High Value Care Task Force of the American College of Physicians and for the Centers for Disease Control and Prevention. Appropriate antibiotic use for acute respiratory tract infection in adults: advice for high-value care from the American College of Physicians and the Centers for Disease Control and Prevention. Ann Intern Med. 2016;164(6):425-434. PMID: 26785402www.ncbi.nlm.nih.gov/pubmed/26785402/. Shulman ST, Bisno AL, Clegg HW, et al. Clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis: 2012 update by the Infectious Diseases Society of America. Clin Infect Dis. 2012;55(10):e86-e102. PMID: 22965026www.ncbi.nlm.nih.gov/pubmed/22965026/. Tanz RR. Acute pharyngitis. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 409. van Driel ML, De Sutter AI, Habraken H, Thorning S, Christiaens T. Different antibiotic treatments for group A streptococcal pharyngitis. Cochrane Database Syst Rev. 2016;9:CD004406. PMID: 27614728www.ncbi.nlm.nih.gov/pubmed/27614728/. Last reviewed on: 7/19/2021 Reviewed by: Linda J. Vorvick, MD, Clinical Associate Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. THURSDAY, Jan. 30, 2020 (HealthDay News) -- When a child has strep throat, an antibiotic like penicillin usually has them back at school 24 hours later. But a new study warns that strains of bacteria that cause strep throat and "flesh-eating disease" appear close to becoming resistant to penicillin and other antibiotics known as beta-lactams. "If this germ becomes truly resistant to these antibiotics, it would have a very serious impact on millions of children around the world," said study lead author Dr. James Musser, chair of pathology and genomic medicine at Houston Methodist Hospital. "That is a very concerning but plausible notion based on our findings," Musser said in a hospital news release. The international team of researchers analyzed more than 7,000 group A streptococcus strains collected over several decades from around the world. They found that about 2% had gene mutations of interest. Tests confirmed that those strains have decreased susceptibility to beta-lactam antibiotics. That suggests these antibiotics may eventually become less effective or completely ineffective against these strains, according to the researchers. The study findings highlight the urgency of developing a vaccine against group A streptococcus, the researchers said. "We could be looking at a worldwide public health infectious disease problem," Musser said. "When strep throat doesn't respond to frontline antibiotics such as penicillin, physicians must start prescribing second-line therapies, which may not be as effective against this organism." Group A streptococcus causes 20%-30% of sore throats in children and 5%-15% of sore throats in adults, according to the U.S. Centers for Disease Control and Prevention. According to the CDC, that same strain is considered the most common cause of the flesh-eating disease necrotizing fasciitis. The bacteria usually enter the body through a break in the skin, and rapid antibiotic treatment is essential. The study was published online Jan. 29 in the Journal of Clinical Microbiology. Musser and his colleagues plan further research to learn how group A streptococcus mutations arise in people, how they may affect health, and how they may alter the virulence of the bacteria. Strep throat is an infection in the throat and tonsils caused by a bacterium known as Streptococcus. With proper treatment, strep is usually cured within 10 days. Treatment includes antibiotics such as penicillin or amoxicillin.
OverviewWhat is strep throat?Strep throat is an infection in the throat and tonsils (glands in the back of the throat) that is caused by a bacterium known as group A Streptococcus. Strep throat spreads from person to person very easily, especially among family members. It is common in school-aged children but also occurs in adults. Strep throat can very rarely cause more serious illnesses, such as rheumatic fever, a disease that can harm the heart valves. So, it's important that strep throat is appropriately diagnosed and treated. With proper treatment, strep throat is usually cured within 10 days. Symptoms and CausesWhat are the symptoms of strep throat?The symptoms of strep throat include:
How does strep throat spread?Strep throat is spread by:
Diagnosis and TestsHow do I know if my child has strep throat?Visit your healthcare provider if the symptoms suggest strep throat. Your child will be examined and may be given a strep test (throat culture). Viral illnesses can have the same symptoms as strep throat. This is why it's important that a throat swab be done to confirm the presence of the Strep bacteria in the throat. What is a strep test?A strep test looks for Streptococcus bacteria in the throat. The test is painless and takes very little time. The tip of a cotton swab is used to wipe the back of your throat. The swab is then tested. The rapid strep test takes approximately 20 minutes. If the test is positive (the Streptococcus bacteria is found), you have strep throat. If the test is negative (no signs of Streptococcus), the doctor may send the throat swab to a laboratory to double-check the results. Some doctors may not do a rapid strep test and instead just send the throat swab to the laboratory. Management and TreatmentHow is strep throat treated?Strep throat is treated using antibiotics. An antibiotic is a type of medicine that kills the bacteria that cause the infection. Antibiotics are often taken as pills or given as a shot. Penicillin and amoxicillin are common antibiotics used to treat strep throat. Other antibiotics are ordered for people who are allergic to penicillin. Your healthcare provider may give your child a shot or prescribe an antibiotic in either pill or liquid form. The pills or liquid are usually taken for 10 days. Follow your healthcare provider's instructions. Your child should take all of the medication, even if he or she feels better. The bacteria can still be alive even if your child feels okay. What can be done to relieve the pain of strep throat?Your child should:
Aspirin should not be given to children. Aspirin can cause Reye's syndrome, a life-threatening illness, in children and adolescents who have fevers. Other sore throats don't need special medicine, so why does strep throat?Most sore throats are caused by viruses, which cannot be cured with medicine; you can only relieve the aches and pains. Viruses heal on their own and cannot be cured with antibiotics or other medicines. Strep throat is caused by a bacterium. Infections caused by bacteria can be treated with antibiotics. Strep throat can lead to more serious illnesses, so it's important to get it treated. Can I take antibiotics I already have in the house for strep throat?You should never take medicines left over from an earlier illness or give a leftover medicine to your children. Leftover antibiotics can also make strep throat more difficult to treat and can cause serious side effects. Outlook / PrognosisHow soon will my child feel better?Your child should feel better within a day or two after treatment begins. When can my child return to school after treatment for strep throat?Your child can return to regular activities, including school attendance, 24 hours after receiving the shot or beginning the antibiotic, if their temperature is normal. Living WithWhat if my child is not getting better after being treated for strep throat?If your child is not getting better, let your healthcare provider know right away. Your child should not stop taking their medicine, unless your healthcare provider tells you to. Call your healthcare provider if your child is not improving one to two days after starting the antibiotic. You should also call if your child has any of these symptoms:
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Can antibiotics make symptoms worse before they get better?If you take an antibiotic when you don't need it – for example, when you have a cold or the flu – it can make you feel worse and make your illness last longer. In fact, when used the wrong way, antibiotics can cause more severe illnesses like diarrhea, nausea and rashes.
How many doses of antibiotics before strep throat feels better?A person will begin to feel better after taking antibiotics for 1–2 days. According to the Centers for Disease Control and Prevention (CDC) , if a person is not feeling better after taking antibiotics for 48 hours, they should see a doctor.
What happens if your strep throat gets worse?If untreated, strep throat can cause complications, such as kidney inflammation or rheumatic fever. Rheumatic fever can lead to painful and inflamed joints, a specific type of rash, or heart valve damage.
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Why is my strep getting worse with antibiotics
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