Strep Throat (cont.)
Who should be tested for strep throat?
There is not an easy system to decide who should be tested for strep throat.
However, there are certain predictors that make the possibility of strep
tonsillopharyngitis likely. These include:
- Children and adolescents between the ages of five and 15
- Late fall, winter, early spring months
- Clinical evidence of acute pharyngitis (redness and swelling in throat,
white discharge on the tonsils)
- Fever of 101 F to 103 F (38 C to 39.4 C)
- Large and tender lymph nodes in the neck
- Absence of upper respiratory infection symptoms, such as
runny nose, nasal
congestion, and cough
Some clinical studies suggest that if all six of these points are present, then
the likelihood of strep throat may be up to 85%. Your doctor may decide if
testing is necessary based on these or other clinical factors.
How is strep infection treated?
Because of potential significant complications (described below), if strep
throat is detected, it must be treated adequately with antibiotics. It is
important to take the full course of antibiotics as prescribed and not to stop
the medication when symptoms resolve. Prematurely discontinuing antibiotics can
result in the infection being inadequately treated, with potentially adverse
consequences or relapse of the infection.
Streptococcus is highly responsive to penicillin and the cephalosporin
antibiotics. Penicillin has shown good effectiveness, and it is reliable and
cheap.
Oral penicillin V
(Pen-Vee-K, Veetids) is the preferred oral form of penicillin for strep throat.
The usual dose is 250 milligrams three times a day or 500 milligrams twice a
day. A full 10 day course must be completed although patients usually feel
better only after two to three days.
Injectable penicillin G (Bicillin) is also very effective and may be used in individuals
who may not reliably take 10 days of antibiotics orally. The drug may last in
the body for up to 21 days and can therefore adequately treat the infection.
Other penicillin derivatives such as amoxicillin (Amoxil),
amoxicillin-clavulanate (Augmentin), cloxacillin
(Cloxapen, Tegopen), and dicloxacillin (Dynapen) are all
adequate treatments for strep. They may be even slightly more effective than
penicillin because of better absorption and greater potency.
Cephalosporin antibiotics are also a very effective in treating group A
streptococcus. In some studies, they were found to be better than penicillin,
and there is some suggestion that they may be the first choice antibiotic for
this infection. For now, they remain a very good choice in patients with mild
penicillin allergies.
Some examples of cephalosporin antibiotics used to treat strep throat are:
Other options are macrolides, such as
erythromycin (E-Mycin, Eryc, Ery-Tab,
PCE, Pediazole, Ilosone), azithromycin (Zithromax), and clarithromycin
(Biaxin). These antibiotics have shown similar to superior effectiveness
compared to penicillin for the treatment of group A streptococcus. Erythromycin
is thought to be the optimum choice for people with severe
penicillin allergy.
The current recommendations still list penicillin as the first choice for the
treatment of group A streptococcus. Erythromycin is recommended as the first
choice in penicillin-allergic individuals. First generation cephalosporins such
as cephalexin and cefadroxil, are alternatives to erythromycin.
Next: When should the tonsils be taken out? »
- amoxicillin, Amoxil, Dispermox, Trimox - Learn more about amoxicillin, including a description, generic and brand names, drug class and mechanism, preparations, storage, reasons for prescription, dosing, effect on pregnancy and nursing mothers, and common side effects.
- Tonsillectomy - Learn about the tonsillectomy or adenoidectomy surgery. Information on what to expect prior to surgery, during surgery, and recovery time from surgery.
- Infectious Mononucleosis - Read about mono treatment, symptoms, signs, risks and diagnosis. "The kissing disease" is a contagious sickness caused by the Epstein Barr virus transmitted in saliva.
Latest Medical News
Cold and Flu RSS