Do I need antibiotics to treat strep throat? - Nebraska Medicine

Strep throat signs and symptoms

Viral infections cause about 80% of sore throats, but strep throat is caused by bacteria called group A streptococcus or group A strep. Strep throat only accounts for about 15% of all sore throats in adults and 30% of sore throats in children.

"Patients often confuse strep throat with other sore throat infections," says Christie Barnes, MD, Nebraska Medicine ear, nose and throat specialist. "A viral sore throat is usually accompanied by a cough, sneeze, runny nose or hoarse voice. Bacterial strep can make it painful to swallow and often comes with a high fever."

Signs and symptoms of strep throat include:

• Throat pain or painful swallowing
• Red and swollen tonsils, sometimes with white patches or pus
• Tiny red spots on the roof of the mouth
• Swollen, tender lymph nodes in your neck
• Fever
• Headache
• Rash
• Nausea or vomiting
• Body aches

Strep throat treatment

Most doctors can diagnose and treat strep throat. If you have a sore throat, your doctor will likely take a swab of your throat to see if you have an infection.

• If the results are negative, your doctor may recommend pain medication and general fluids to manage your symptoms
• If the swab is positive for streptococcus, your doctor will likely recommend antibiotics to ensure the infection doesn't turn into something more serious

Left untreated, strep throat can cause:

• Kidney damage – caused by the immune system's response to fight off strep throat
• Scarlet fever – symptoms include bright red rash, sore throat and high fever
• Rheumatic fever – a condition that causes painful joints, rash and heart problems
• Pneumonia – symptoms vary from mild fever and cough to difficulty breathing and sepsis

If you're experiencing one or more of the below symptoms, your doctor may refer you to an ear, nose and throat specialist, or ENT doctor, for additional testing.

• Severe throat pain
• White spots on your tonsils
• Painful or difficulty swallowing
• Swollen or tender lymph nodes in your neck

Depending on your condition, the ENT doctor may recommend a tonsillectomy to remove your tonsils. Often considered a rite of passage for many children, tonsil removal can also be helpful for adults with reoccurring throat and tonsil issues.

How to prevent strep throat from spreading

Strep throat can spread through direct contact, such as kissing or sharing utensils. You usually aren't contagious 48 hours after starting antibiotics. If you choose not to take antibiotics, you may be contagious for up to three weeks.

While there is no vaccine to prevent strep throat, there are steps you can take to protect yourself and others:

• Frequently washing your hands
• Covering your mouth when you cough or sneeze
• Avoiding sharing utensils and drinking glasses while you are sick
• Avoiding kissing anyone while you are contagious

If you or your child has a sore throat, it's a good idea to consult a doctor in person or through a telehealth visit. For more information, call 800.922.0000.