What Type Of Antibiotics Are Used For Strep Throat

Who Is Most At Risk Of Invasive Group A Streptococcal Disease

Few people who come in contact with a virulent strain of GAS will develop invasive GAS disease most will have a routine throat or skin infection and some may have no symptoms whatsoever. Although healthy people can get invasive GAS disease, people with chronic illnesses like cancer, diabetes and kidney dialysis, and those who use medications such as steroids, are at higher risk. In addition, breaks in the skin, like cuts, surgical wounds or chickenpox, may provide an opportunity for the bacteria to enter the body.

When And Why You Might Need An Antibiotic For A Cold

Daniel More, MD, is a board-certified allergist and clinical immunologist with a background in internal medicine.

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Any given adult will get a cold at least a couple of times a yearusually in the fall and winter. Kids can get many colds, maybe even half a dozen or more a year. When you get a cold, also known as an upper respiratory tract infection, should you visit your healthcare provider and get antibiotics?

The truth is, antibiotics for respiratory infections arent going to make you feel better sooner, and they might even leave you with side effects that make you feel worse.

Colds are known medically as upper respiratory tract infections because theyre usually limited to the upper half of your respiratory systemthe nose, sinuses, upper throat, larynx, and pharynx. These infections dont, for example, include infections that affect your lungs, like pneumonia.

Upper respiratory tract infections are usually caused by viruses, like rhinovirus, coronavirus, or influenza, though rarely they are caused by bacteria. Bacteria that infect the upper respiratory tract are most often S. pyogenes , or sometimes H influenzae.

Due to the development and routine administration of the H. influenzae vaccine over the past 30 years, the incidence of this infection has dropped substantially.

Antibiotics may be prescribed in a few different situations:

Other Upper Respiratory Tract Infections

There are a few other reasons you might be prescribed antibiotics for an upper respiratory infection. Strep throat, medically known as streptococcal pharyngitis, is a sore throat caused by infection by streptococcal bacteria. It is usually treated with penicillin.

Swelling of the epiglottis, the flap of tissue covering the windpipe, is potentially life-threatening, particularly in children ages 2 to 5 years. Called epiglottitis, this condition can impact breathing and is often caused by infection with the bacteria Haemophilus influenzae type b and should be treated with antibiotics, including a cephalosporin.

If the cold leads to an ear infection, antibiotics may help resolve it if pain relievers and decongestants dont do the trick. Antibiotic use guidelines for children with ear infections differ based on their age and symptoms.

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Clinical Guidelines For Gabhs

How should physicians choose among the many different methods available to diagnose GABHS? Guidelines developed by professional associations can help medical professionals choose among available techniques. One set of guidelines is endorsed by the Centers for Disease Control , American Academy of Family Physicians , and the

American College of PhysiciansAmerican Society of Internal Medicine . Published in 2001, these guidelines recommend combining the Centor clinical decision rule with RADTs to diagnose GABHS. No testing is suggested for patients with Centor scores from zero to one. For individuals with scores from two to four the guidelines offer three options: test patients using RADTs and treat those with positive results, test patients with scores from two to three and treat those with positive tests and scores of four, and empirical treatment of patients with scores from three to four. The guidelines assert that no backup throat testing for negative RADTs is required if the sensitivity of the tests exceeds 80% .

How Common Is Invasive Group A Streptococcal Disease

Approximately 9,000-11,500 cases of invasive GAS disease occur in the United States each year resulting in 1,000-1,800 deaths. The Centers for Disease Control and Prevention estimates that less than 10% of these are cases of necrotizing fasciitis and STSS. In contrast, there are several million cases of strep throat and impetigo annually. Clusters of cases or outbreaks of invasive GAS have not been reported in any schools or communities in New York State.

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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.

Has Early Prompt Antibiotic Treatment Suppressed Natural Immunity

With the availability of rapid strep detection tests and the publication of several convincing studies that describe faster clinical improvement from prompt treatment, many physicians have been prescribing antibiotics sooner after diagnosing strep throat infections.

Immediate penicillin treatment has been shown to be a cause of recurrent strep infections. Early antibiotic treatment suppresses the natural immune response to strep. Delaying antibiotic therapy for two days after the onset of a sore throat allows an immune response to develop, which may reduce the chance of a relapse or recurrence of strep throat infections.

Two similar studies compared immediate penicillin treatment with treatment delayed for 48 to 56 hours in 343 children with documented strep throats. Early antibiotic therapy produced a three-time increase in the frequency of recurrent infections as compared to those for whom treatment was delayed.

A delay in treatment does not increase the risk of rheumatic fever since a delay of up to nine days from the onset of symptoms can be made. Nevertheless, for patients who appear severely ill or in times when highly infectious strains of strep are circulating, intentionally delayed treatment should not be considered.

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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.

What Matters Most To You

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to take antibiotics for a sore throat

Reasons not to take antibiotics for a sore throat

I want to take medicine even if theres only a chance it will help me get well faster.

I may not want to take medicine if it wont help me get well faster.

Im worried about my sore throat turning into an ear infection or sinus infection.

Im not worried about my sore throat turning into an ear infection or sinus infection.

Im not worried about the risk of taking antibiotics too often.

Im worried about the risks of taking antibiotics too often.

Ive had a sore throat for more than a week, and its not getting better.

Ive had a sore throat for just a few days.

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Are Antibiotics Always Necessary To Treat A Strep Throat

Although most Strep throats will get better by themselves, there is a risk of acute rheumatic fever and other complications occurring. The CDC recommends that all patients, regardless of age, who have a positive rapid antigen detection test or throat culture receive antibiotics.

Antibiotics have been shown to:

• Shorten the duration of Strep throat symptoms
• Reduce the likelihood of transmission to family members, friends, and other close contacts
• Prevent the development of rheumatic fever and other complications.

Viral sore throats should not be treated with antibiotics. Treatment is usually given for ten days and liquid antibiotics can be given to children who are unable to swallow tablets or capsules. Some patients may benefit from a single shot of penicillin intramuscularly.

Home Remedies For Sore Throat

Whether you have strep or just a sore throat, unwanted symptoms can bring a world of hurt. Here are some natural remedies for a painful sore throat:

• Over-the-counter pain medication such as NSAIDs¹
• Warm drinks, like hot tea
• Gargling salt water
• Avoid spicy or acidic foods
• Avoid areas where people are smoking

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Related Resources For Strep Throat

* Prescription savings vary by prescription and by pharmacy, and may reach up to 80% off cash price.

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This article is not medical advice. It is intended for general informational purposes and is not meant to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. If you think you may have a medical emergency, immediately call your physician or dial 911.

New Types Of Antibiotics In The Treatment Of Strep Throat

Strep throat is inflammation and swelling of the throat, tonsils and lymph nodes due to infection with group A streptococcus bacteria. Strep throat is very contagious and the bacteria responsible for causing the illness can be easily acquired by entering in contact with contaminated people. Streptococcus bacteria are airborne and they can be transmitted through droplets of mucus produced by cough or sneezing. The incubation period of strep throat is around three days and most symptoms of the illness emerge after this period of time. Strep throat usually generates symptoms such as cough, throat inflammation and pain, nausea, fatigue, weakness, headache and moderate to high fever. In order to prevent the occurrence of complications, doctors recommend treating the illness with antibiotics.

Although they have been used in strep throat treatments for decades, some old-fashioned antibiotics such as penicillin and amoxicillin seem to be less effective in overcoming the illness these days. Doctors claim that bacterial strains have mutated and evolved considerably lately, rendering some forms of treatment ineffective in fighting infections. The primary cause for the increased resistance of bacteria to penicillin and amoxicillin is inappropriate treatment. Physicians explain that the misuse of antibiotics allows bacteria to adapt and even become immune to various types of medications.

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Can Invasive Group A Streptococcal Disease Be Treated

Group A streptococcus bacteria can be treated with common, inexpensive antibiotics. Penicillin is the drug of choice for both mild and severe disease. For penicillin-allergic patients with mild illness, erythromycin can be used, although occasional resistance has been seen. Clindamycin may be used to treat penicillin-allergic patients with more severe illness and can be added to the treatment in cases of necrotizing fasciitis or STSS. Certain other antibiotics also are effective. In addition to antibiotics, supportive care in an intensive care unit and sometimes surgery are necessary with these diseases. Early treatment may reduce the risk of death although, unfortunately, even appropriate therapy does not prevent death in every case.

Testing Confirms Presence Of Bacteria

Classic symptoms of strep throat include a painful sore throat, difficulty swallowing, fever, swollen neck glands, nausea, and headache. Upon examination, the throat appears red, often with white or yellow dots or streaks, tiny red dots on the upper palate, and swollen tonsils. Sore throats accompanied by cold or flu-like symptoms, such as nasal congestion and cough, are typically caused by a virus, and antibiotics are not effective to kill viruses. To avoid the unnecessary use of antibiotics and development of resistance, the diagnosis of a bacterial infection is essential before prescribing antibiotics. Since symptoms alone cannot definitively diagnose strep throat caused by bacteria, a rapid strep test detects the presence of a bacterial infection using a swab of the throat, followed by a culture if the rapid test is negative.

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Treating Strep Throat With Z

If your doctor thinks azithromycin is a good choice for you, they may prescribe a generic version of azithromycin or a Z-Pack.

Each Z-Pack contains six 250-milligram tablets of Zithromax. You would take two tablets on the first day, followed by one tablet daily for four days.

A Z-Pack typically takes at least five days to fully work, but it can start to relieve your sore throat and other symptoms on the first day you take it. If your doctor prescribes a generic version of azithromycin, your treatment may only last three days.

Be sure to take your Z-Pack or generic azithromycin exactly as your doctor prescribes. This is true even if you feel better before youve taken the full course of treatment.

If you stop taking an antibiotic early, it could make the infection come back or make future infections more difficult to treat.

Treating Strep Throat With Antibiotics

Oral antibiotics are the most common and effective treatment for strep throat.

These can work to slightly reduce the duration and severity of symptoms, prevent complications, and limit the spread of infection to others.

Sore throat may persist for up to a week even with antibiotic treatment, but antibiotics decrease the duration of symptoms by about one day, and should prevent symptoms from worsening within 2-3 days.

You should never be given antibiotics without a positive diagnosis of strep via testing or evaluation by a licensed healthcare provider.

If your strep test is negative, your symptoms are likely caused by a virus and antibiotics will not help and instead may be harmful.

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Diagnostic Methods For Gabhs

GABHS manifests as throat pain, fever, headaches, and chills . These symptoms overlap with non-GABHS and viral causes of acute pharyngitis. Therefore, obtaining an accurate differential diagnosis based solely on a patients symptoms is difficult. A careful physical examination and patient history is the starting point for diagnosing GABHS. Diagnosis of GABHS over the phone is not advised, as the pharynx and cervical lymph nodes cannot be examined . Furthermore, patients have difficulty in accurately measuring the severity of their symptoms, creating a positive diagnostic bias .

After a physical examination and patient history is completed, five types of diagnostic methods can be used to ascertain the presence of a GABHS infection. The first is clinical scoring systems. The second is rapid antigen detection tests. The third is throat culture. The fourth is nucleic acid amplification tests. The fifth is machine learning and artificial intelligence.

How Are Group A Streptococci Spread

These bacteria are spread by direct contact with nose and throat discharges of an infected individual or with infected skin lesions. The risk of spread is greatest when an individual is ill, such as when people have strep throat or an infected wound. Individuals who carry the bacteria but have no symptoms are much less contagious. Treatment of an infected person with an appropriate antibiotic for 24 hours or longer eliminates contagiousness. However, it is important to complete the entire course of antibiotics as prescribed. Household items like plates, cups and toys do not play a major role in disease transmission.

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Machine Learning And Artificial Intelligence

In the past few years machine learning and artificial intelligence techniques have been proposed to help physicians diagnose strep throat. One novel approach uses the camera and flashlight built into a smartphone to take a picture of a patients throat. An add-on device is attached to the smartphone to minimize the reflection of light into the camera sensor. Image correction algorithms are then implemented, and k-fold validation applied for classification. Experimental results from a sample of 28 healthy and 28 strep-positive subjects show that the image processing method has specificity of 88% and sensitivity of 88% . Given the small sample-size this approach will require validation in future studies. Another method that has been suggested is to program neural networks to assist diagnosis. One study using data from thirty-eight variables contained in 240 patients medical records found that a neural network can correctly diagnose pharyngitis in 95.4% of cases . Whether this promising result can be replicated in diagnosing GABHS should be examined. Artificial intelligence software has also been employed to automate the process of examining throat cultures to identify GABHS. Automatic detection of GABHS produces results that are superior to classification decisions made by lab technicians, improving diagnostic accuracy .

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 don’t 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.

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