Monday, November 21, 2022

Antibiotic Of Choice For Strep Throat

What Antibiotic Is Used For Strep Throat

Streptococcal Pharyngitis

Health care professionals consider penicillin or amoxicillin the best first-line treatments for strep throat. According to the CDC, There has never been a report of strep that is resistant to penicillin. For people with a penicillin allergy, doctors will recommend either a narrow-spectrum cephalosporin, clindamycin, Azithromycin, or clarithromycin.

Antibiotic treatment for strep throat can:

  • Reduce the severity and length of strep throat symptoms
  • Lower the risk of passing it on to family, friends, and close contacts
  • Stop rheumatic fever and other complications from developing

Has Prior Antibiotic Therapy Eliminated Protective Throat Bacteria

Prominent, normal bacteria of the throat include another type of streptococci . These bacteria make natural antibiotic substances in the throat. Penicillin or amoxicillin therapy may change the natural environment for throat bacteria by killing these alpha hemolytic streptococci their elimination provides an opportunity for disease-causing strep to gain access to the throat cells. This is another reason for patients to avoid unnecessary antibiotic use.

Antibiotics Get You Well Fast

Doctors treat strep throat with antibiotics. Either penicillin or amoxicillin are recommended as a first choice for people who are not allergic to penicillin. Doctors can use other antibiotics to treat strep throat in people who are allergic to penicillin.

Benefits of antibiotics include:

  • Preventing the bacteria from spreading to others
  • Preventing serious complications like rheumatic fever

Someone who tests positive for strep throat but has no symptoms usually does not need antibiotics. They are less likely to spread the bacteria to others and very unlikely to get complications. If a carrier gets a sore throat illness caused by a virus, the rapid strep test can be positive. In these cases, it can be hard to know what is causing the sore throat. If someone keeps getting a sore throat after taking the right antibiotics, they may be a strep carrier and have a viral throat infection. Talk to a doctor if you think you or your child may be a strep carrier.

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What Are The Recommended Dosages Of Antibiotics Used To Treat Strep Throat

Antibiotic dosages can vary depending on age and weight. The CDC recommends the following dosages of antibiotics for Strep throat, for those people without a penicillin allergy. One dosage regimen should be chosen that is appropriate for the person being treated.

Oral Penicillin V

  • Children: 250mg twice daily or 250mg three times daily for 10 days
  • Adolescents and adults: 250mg four times daily or 500mg twice daily for 10 days

Oral amoxicillin

  • Children and adults: 50 mg/kg once daily for 10 days
  • Children and adults: 25 mg/kg twice daily for 10 days

Intramuscular Benzathine penicillin G

  • Children < 27 kg: 600 000 units as a single dose
  • Children and adults 27 kg: 1 200 000 units as a single dose

The CDC recommends the following dosages of antibiotics for Strep throat, for those people with a penicillin allergy. One dosage regimen should be chosen that is appropriate for the person being treated.

  • Oral cephalexin 20 mg/kg twice daily for 10 days
  • Oral cefadroxil 30 mg/kg once daily for 10 days
  • Oral clindamycin 7 mg/kg three times daily for 10 days
  • Oral azithromycin 12 mg/kg once daily for the first day , followed by 6 mg/kg once daily for the next 4 days
  • Oral clarithromycin 7.5 mg/kg twice daily for 10 days.

Preventing The Spread Of Infection:

Why You Shouldn

Since Streptococcus bacteria are highly contagious through saliva and nasal secretions, prevention of the spread of strep is similar to viral cold or influenza prevention. This includes hand washing and covering the mouth and nose when coughing or sneezing. Patients should not return to school, day care, or work until they are no longer contagious and have no fever, usually 24 to 48 hours after beginning antibiotics. It is important to finish the entire course of antibiotics even if symptoms disappear, so the infection does not return. If strep throat returns after treatment with antibiotics, there may be close exposure to a strep carrier, a person who carries the Streptococcus bacteria in the throat but has no symptoms of a strep infection. In these cases, it is appropriate to treat the strep carrier to stop recurring infections. Otherwise, strep carriers do not require antibiotics, since they are not at risk of strep infection complications. Streptococcus bacteria can also remain alive on objects such as a toothbrush for several days, so replacing a toothbrush after 24 to 48 hours of antibiotic therapy and thoroughly cleaning orthodontic retainers every day can prevent patients from reinfecting themselves.

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Data Collection And Analysis

Two review authors independently screened trials for inclusion, and extracted data using standard methodological procedures as recommended by Cochrane. We assessed risk of bias of included studies according to the methods outlined in the Cochrane Handbook for Systematic Reviews of Interventions and used the GRADE tool to assess the overall quality of evidence for the outcomes.

Description Of The Intervention

The administration of antibiotics is likely to shorten the time to the remittance of symptoms and reduce the likelihood of complications in patients whose sore throat has a bacteriological aetiology . However, their benefits may be limited in the treatment of sore throat more generally . Traditionally, doctors have attempted to decide whether the cause of the infection is bacterial, especially when caused by the group A betahaemolytic Streptococcus . However, deciding the aetiological agent is difficult .

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What Is The Best Medication For Strep Throat

The best medication for treating strep throat should be discussed with your doctor and will depend on your medical history and current medications you may be taking.

Best medications for treating strep throat
Drug name
300 mg every 6 hours Kills the bacteria causing strep throat Skin problems, yellow appearance of skin, nails, or whites of eyes

Dosage is determined by your healthcare provider based on your medical condition, response to treatment, age, and weight. Other possible side effects exist. This is not a complete list.

Special Considerations For Populations With Known Or Potential High Risk For Arf

Streptococcal Pharyngitis

In populations at higher risk for ARF, such as children living in the Canadian North or in overcrowded housing conditions, and Indigenous and Pacific Islander children, a high index of clinical suspicion for GAS is needed . For these children, the risks of acquiring or worsening ARF may exceed the risks of selective testing and treatment as currently recommended for populations at low risk for ARF. Widespread availability of RADT could increase detection of GAS pharyngitis in rural, remote, or under-resourced communities. However, access to throat culture is important to rule out false negative RADT results . In situations where no testing is available, consider empiric treatment for children with CENTOR scores > 3.

Crucially, improving access to health services, having adequate supply of oral penicillin and amoxicillin, providing education about GAS and ARF, and addressing housing needs are essential to ensure health equity for First Nations, Inuit, and Métis children and other populations at higher risk of ARF. More research is needed to understand the burden of ARF in Canadas Indigencous populations.

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How To Use Cefixime Oral

Take this medication by mouth with or without food as directed by your doctor, usually once a day. In children, this medication may also be taken twice a day . If you are taking the chewable tablets, chew thoroughly and then swallow.

The dosage is based on your medical condition and response to treatment. In children, the dosage is also based on weight.

For the best effect, take this antibiotic at evenly spaced times. To help you remember, take this medication at the same time every day.

Continue to use this medication until the full prescribed amount is finished, even if symptoms disappear after a few days. Stopping the medication too early may allow bacteria to continue to grow, which may result in a relapse of the infection.

Tell your doctor if your condition persists or worsens.

What Is Strep Throat And How Do People Get It

Strep throat is a specific type of bacterial infectionâgroup A Streptococcus, in medical parlance.

That differs from other illnesses that give us sore throats and coughs, which are usually viral infections that donât need to be treated with antibiotics, and go away on their own.

Strep bacteria live in the nose and spread when an infected person coughs or sneezes and spreads respiratory droplets to other people. You can catch strep from an infected person if you:

  • Inhale the droplets

  • Touch something the droplets have landed onâlike a doorknobâand then touch a mucous membrane

  • Touch an open sore that was caused by group A Strep

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Can An Online Doctor Treat Me For Strep Throat

Yes! HealthTap is here to help.

Our online doctors can meet you via video consultation and evaluate you for strep throat, order tests*, offer medical advice, and write prescriptions that are sent electronically to your nearest pharmacy. HealthTap members can compare costs at the nearest five pharmacies and save up to 75% off the cost of their prescriptions. Additionally, if you schedule an appointment with a primary care physician in our Virtual Primary Care clinic, you can text with your doctor for free after your appointment to discuss any questions or clarifications you may have.

*You may need to travel to an in-person clinic if testing for strep is needed.

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What Antibiotic Should Be Selected

Does bactrim cover strep

Many antibiotics—such as penicillin-can be used to treat recurrent strep throat infections.

Clindamycin or rifampin, in combination with a second antibiotic, such as penicillin, amoxicillin, or a cephalosporin, has been used to treat acute, recurrent, and carrier strep throat infections. Routine use of clindamycin is not advocated because diarrhea is a rare, but significant, side effect. Rifampin must be used with a second antibiotic because strep will rapidly become resistant to it when it is given as a single therapy. Patients should be advised that rifampin produces orange discoloration of the urine and tears .

Oral cephalosporins have gained widespread use in treating recurrent strep throat infections. When cephalosporin antibiotics are used to treat strep throat infections, a failure occurs less than 5% of the time however, they are more expensive than penicillin or amoxicillin.

Amoxicillin/clavulanic acid has been evaluated to treat strep throat with superior or equivalent results in comparison to penicillin.

Table 4.

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Who To Test: Clinical Presentation And Diagnosis

GAS pharyngitis is characterized by fever > 38.0°C, moderate to severe sore throat, very tender anterior cervical lymphadenopathy, absence of cough and rhinorrhea, and inflamed and/or purulent tonsils. Clinical presentation varies considerably among studies and countries . Symptoms are generally self-limited, resolving without treatment in 4 to 5 days. GAS pharyngitis is rare in children < 3 years of age, and testing is only indicated in outbreak settings or when scarlet fever is suspected.

Positive throat cultures in children with symptoms of viral upper respiratory infection and sore throat often indicate GAS carriage in the setting of viral pharyngitis. Antimicrobial stewardship initiatives, including Choosing Wisely Canada, promote judicious use of investigations and antibiotics when pre-test probability is low . Clinical decision rules, such as CENTOR , can assist in identifying patients with higher risk for GAS who warrant testing. These are not treatment criteria, however .

Box 1. CENTOR Clinical decision rule
One point for each characteristic:

  • Exudate or swollen tonsils
  • Tender or swollen anterior cervical lymph nodes

If the total score is 3, do a throat swab. There is a 32% to 56% probability of GAS infection in such cases.

Based on reference

Are The Sore Throats Actually Caused By Strep

Many physicians diagnose strep throat infections based on a patient’s history and an examination. However, without the aid of a throat culture or a rapid strep detection test, recurrent strep throat infections are difficult to accurately diagnosis. The complaint of a sore throat is frequent in the primary care practice setting. Yet, at the peak of the strep throat infection season , strep is the cause of a sore throat in less than 30% of children and 10% of teenagers.

Therefore, strictly on a percentage basis, physicians, who diagnose strep in the majority of patients with a sore throat, over-diagnose 90% of teenagers and 70% of children. Even in a patient with typical symptoms-a fever, a red throat with yellow pus on the tonsils, swollen and tender neck lymph glands, and the absence of a runny nose and a cough-misdiagnosis is common. In one study, an overestimate of the probability of a positive strep culture was observed for 81% of the patients.

To accurately diagnose strep throat infections, physicians use throat cultures or rapid strep detection tests. Rapid strep detection tests improve the accuracy of diagnosing strep throat infections. The accuracy of rapid strep detection tests varies between products, but the main variable is in the carefulness of performing the test. The critical factor is attention to detail and strictly following the manufacturers’ guidelines for the test.

Table 1.

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Management Of Recurrent Gabhs Pharyngitis

RADT is effective for diagnosing recurrent GABHS infection. In patients treated within the preceding 28 days, RADT has similar specificity and higher sensitivity than in patients without previous streptococcal infection .38 Recurrence of GABHS pharyngitis within one month may be treated using the antibiotics listed in Table 3.2,1720,2834 Intramuscular penicillin G injection is an option when oral antibiotics were initially prescribed.

What Happens At Your Appointment

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The GP will try to work out what has caused your laryngitis.

They may:

  • look inside your throat using a small mirror
  • wipe a cotton bud around the back of your throat for testing
  • arrange a blood test
  • refer you to an ear, nose and throat specialist

If your laryngitis is caused by an infection, the GP might prescribe antibiotics.

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What Is Group A Streptococcus

Group A streptococci are bacteria commonly found in the throat and on the skin. The vast majority of GAS infections are relatively mild illnesses, such as strep throat and impetigo. Occasionally, however, these bacteria can cause much more severe and even life threatening diseases such as necrotizing fasciitis and streptococcal toxic shock syndrome . In addition, people may carry group A streptococci in the throat or on the skin and have no symptoms of disease.

Is The Patient Not Responding To Antibiotics

Even when all strep infections are laboratory confirmed with throat cultures or rapid strep detection tests, and the antibiotic is finished, failure to respond to treatment still occurs. The highest treatment failure rates observed are with penicillin about two-thirds of presumed strep throat infections are treated with either penicillin or amoxicillin. Penicillin and amoxicillin treatment failures vary geographically, and the incidence of penicillin treatment failures for strep throat infections may be rising. Patients most likely to experience a penicillin or amoxicillin treatment failure are those who have recently received treatment with these drugs and are then retreated with the same antibiotic.

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Uses Of Clarithromycin And Azithromycin

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Azithromycin administered for 5 days or clarithromycin for 7 to 10 days for the treatment of acute otitis media in children has been effective,245,246 but use is limited due to increasing macrolide resistance amongstS. pneumoniae isolates, and cases of meningitis have been reported during oral therapy.247

Z. Hossain, in, 2014

Is The Patient Experiencing Repeated Exposure To Strep

Natural Remedies for Strep Throat

Some patients are effectively treated for a strep infection with antibiotics, only to return to an environment where the infection continues to circulate. The patient then becomes re-infected and returns to the physician with a recurrent strep throat infection. Certain circumstances-crowded working conditions, schools, day care settings, and larger families-more frequently transmit strep. One small study and one case report have suggested that, in rare instances, dogs also may be carriers of strep however, other investigations have not corroborated this possibility.

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What Are The Risks Of Taking Antibiotics For Sore Throat

Antibiotics may cause side effects, such as diarrhea, vomiting, and skin rashes.

Besides side effects, there are other good reasons not to use antibiotics unless you really need them.

  • Antibiotics cost money.
  • You will probably have to see the doctor to get a prescription. This costs you time.
  • If you take antibiotics when you dont need them, they may not work when you do need them. Each time you take antibiotics, you are more likely to carry some bacteria that were not killed by the medicine. Over time, these bacteria get tougher and can cause longer and more serious infections. To treat them, you may need different, stronger, and more costly antibiotics.

Are Strep Throats Contagious

Yes, Strep throats are contagious, and the bacteria are easily transmitted and spread by coughing or sneezing or after coming into contact with infected droplets, and then touching your mouth, nose, or eyes. Transmission of bacteria can also occur via contact with people with Scarlet fever, or other group A skin infections.

Without treatment, people with Strep throat can pass on the bacteria to others for one to two weeks after symptoms appear. The best way to prevent infection is to wash your hands often and always before eating or after being in contact with an infected person. Do not share utensils, linen, or personal items. People with Strep throat or scarlet fever should stay home for at least 24 hours after starting antibiotics or until they feel well enough to return to school or work.

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