How Strep Throat Is Treated

Strep throat is treated with prescription antibiotics, such as penicillin, amoxicillin, and erythromycin, among others. Sometimes, over-the-counter options like ibuprofen or home remedies can reduce pain and ease other uncomfortable symptoms. If you have symptoms, you should see your healthcare provider to find out whether you have strep throat—an accurate diagnosis will help you get the right treatment for the infection and help prevent complications of a persistent infection.

Prescriptions

Prescription antibiotics are the treatment of choice for strep throat for several reasons:

• Proper treatment reduces the duration of symptoms.
• Treatment helps prevent the rare but serious complications of untreated streptococci infections, such as rheumatic fever (immune system-triggered damage to heart valves) or glomerulonephritis (damaged kidneys). 
• Treatment reduces the spread of infection.

Selection of Antibiotics

If you do not have an allergy to penicillin, you will likely be prescribed:

• Penicillin V
• Amoxicillin

Any antibiotic that ends in -cillin is part of the penicillin family and will not be used if you have a penicillin allergy.

If you do have a penicillin allergy, there are safe alternatives to the above:

• Cephalexin
• Cefadroxil
• Clindamycin
• Azithromycin
• Erythromycin
• Clarithromycin

Effectiveness

How well an antibiotic works for you depends on a few factors, including:

• Whether or not you really have Strep: Antibiotics are not effective against viral infections, like the common cold or the flu. Before your healthcare provider prescribes an antibiotic, you need to have verification that you truly have strep throat (either via a rapid strep test or a throat culture). 
• Taking antibiotics as directed: Not completing the full course of antibiotics can predispose you to persistent strep throat and the risk of acquiring other illnesses like rheumatic fever or kidney disease. The bacteria may also become resistant to the antibiotic that you didn't complete, adding to your chances of developing antibiotic-resistant strep infection.

Precautions and Considerations

There are many different kinds of bacteria that normally live in the back of the throat and don't make you sick. In fact, these bacteria, called "normal flora," actually help prevent the growth of harmful bacteria.

Many antibiotics destroy normal flora along with harmful bacteria. Losing that protection that you would usually get from normal flora can cause you to contract another case of strep throat within the first month or so after your initial treatment—even if your first course of antibiotics was successful.

If you stop early before the infectious bacteria is eradicated, resistant strains can begin to multiply, and they will be far less responsive to treatment in the future. Antibiotic resistance has been reported with the antibiotics used to treat strep throat, though resistant bacterial strains are not common. Resistance has been reported with all antibiotics, especially with Zithromax (azithromycin). 

If an initial course of antibiotics does not work for you, a new antibiotic typically will.

Over-the-Counter Therapies

If you have strep throat, some over-the-counter therapies can help relieve some of your symptoms as you recover, but they cannot treat the infection or prevent complications. 

• Tylenol (acetaminophen) or Advil (ibuprofen): These medications can reduce your fever and help with pain; ibuprofen can also help reduce inflammation.
• Throat Sprays: Products like Chloraseptic contain topical anesthetics (benzocaine, phenol) that can help ease throat pain.
• Throat Lozenges: There are dozens of options, but you may especially benefit from choosing one that contains an anesthetic. The effect of such lozenges may last longer than that of throat sprays.

Home Remedies

Home remedies can make you more comfortable if you have strep throat, but they cannot cure the infection. They are short-term solutions and do not provide lasting relief.

Some home remedies you may find helpful include:

• Ice packs if you feel hot or if you have a fever
• Warm blankets, warm drinks, and warm food if you feel cold or if you are experiencing chills
• Eating soft foods that do not irritate your sore throat
• Drinking fluids so that you will not become dehydrated
• Cold food and drinks, such as popsicles or ice cream may ease the pain and discomfort of a sore throat
• Saltwater gargle may provide some throat comfort
• Using a cool-mist vaporizer or humidifier for comfort

Surgery

If you have had strep throat seven or more times in one year, your healthcare provider may recommend a tonsillectomy. This procedure is more common for children than adults, primarily because children have a higher tendency to experience recurrent strep throat infections. 

In most cases, a tonsillectomy will solve the problem of recurring strep throat, but not always. Speak with your/your child's healthcare provider about the possible reasons for recurring strep throat and the benefits and risks of surgery as you are considering this procedure.

Most people can go home on the same day or within 24 hours after surgery. Recovery generally takes five to 10 days. During recovery, cold foods and drinks are recommended for comfort and to decrease swelling. 

Complementary Medicine (CAM)

There are no effective complementary treatments that can cure strep throat, but you can get some relief from these options. The CAM treatments listed here are safe, but they can't replace medical treatment—you can use them along with the medical treatments recommended by your healthcare provider.

• Honey may ease the sore throat symptoms of infections such as strep or the common cold, and it is considered safe for children over age 1 and adults. You can use honey to sweeten warm beverages or just eat a spoonful.
• Throat lozenges, which often contain herbal ingredients such as slippery elm, are also found to be effective for alleviating the discomfort of a sore throat, particularly after surgery.
• In general, relaxation, mindfulness, and stress reduction can optimize your immune system function to reduce your chances of becoming sick in the first place, but these techniques cannot completely prevent you from acquiring infections such as strep throat.

Research

There has been some research looking at potential CAM treatments for Strep throat, and some treatments that have had interesting results in a laboratory setting have not been proven to help treat the infection in humans.

• A study found that garlic can inhibit some activity of the strep bacteria in a laboratory setting, but this has not been replicated in human infection.
• Similarly, another study found that echinacea extractIon may have an activity that is harmful to the strep bacteria in a lab setting, but the same can't be assumed in humans.

Prevention

Even though strep throat is contagious, you can take steps to prevent spreading it and to reduce your chances of catching it from others.

In general, try to avoid contact with people who are strep throat carriers. If you live with someone who has this infection, do your best to avoid using the same utensils, straws, or toothbrush holder. The less you share, the safer you'll be.