wikiHow to Evaluate and Treat Strep Throat

Three Parts:Diagnosing Strep ThroatTreating Strep ThroatPreventing Strep Throat

A sore throat does not automatically mean you have strep throat. In fact, most sore throats are caused by viruses, such as the common cold, and will go away on their own. Strep throat, on the other hand, is an infection caused by a bacteria that requires treatment with antibiotics. Learning to evaluate the symptoms of strep throat will help you seek the proper medical attention you need to recover from the illness.

Part 1
Diagnosing Strep Throat

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    Understand what strep throat is. Strep throat is contagious bacterial infection caused by Streptococcus pyogenes, also known as group A streptococcus.[1] Although the hallmark symptom of strep throat is a sore throat, not all sore throats are a result of an bacterial infection caused by streptococcus. In fact, most of the time, sore throats are a result of common viruses and do not need treatment.[2]
    • However, if you do have strep throat treatment is important, as it can cause serious complications including spreading of infection to blood, skin and other organs, rheumatic fever that can affect your heart and joints, and kidney inflammation.
    • The most common age group affected is five to 15 years old, however anyone can get strep throat.
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    Watch for symptoms of strep throat. Seeking medical attention is important because doctors can do quick tests to determine if the infection you have is strep throat. Sometimes you may have symptoms of strep throat, but you may not actually have strep throat. One important thing to keep in mind is that there is no cough with strep throat. Symptoms of strep throat may include any of the following:[3]
    • flu like illness lasting for two to five days
    • fever (which worsens on the second day)
    • sore throat, stomach ache
    • nausea, lack of energy
    • difficulty swallowing, headache
    • swollen lymph nodes
    • rash
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    Call your doctor and follow recommendations for testing and treatment. Based on your symptoms your doctor may recommend coming in for a throat swab strep test. This will only take a few minutes and is the only way to definitively diagnose strep throat. You cannot diagnose strep throat just by looking at it.
    • The “throat swab” test is a rapid antigen test. This test detects strep bacteria in a few minutes. It works by looking for substances (antigens) in the throat. Although this is fast, it may not always be accurate. In some cases, the swab test will come back negative even if you have strep throat. If your doctor thinks that you have strep throat, s/he may culture the test to see if the streptococcus bacteria grows on the swab in the next one to two days.[4]
    • If your swab test or culture comes back positive, your doctor will prescribe a course of treatment that includes a course antibiotics.
    • If your doctor does not diagnose you with strep throat, it's possible that you have anything from a common cold to more serious condition like tonsillitis or mononucleosis.
    • In some cases, the swab test will come back negative even if you have strep throat.[5] If your doctor thinks that you have strep throat, she or he may culture the test to see if the streptococcus bacteria grows on the swab in the next one to two days.

Part 2
Treating Strep Throat

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    Start your course of antibiotics. If your doctor determines that you have the streptococcus bacteria, then you will need to take antibiotics. Antibiotics are usually taken for 10 days, although your doctor may want you to take them for shorter or longer. The most common antibiotics prescribed for strep throat include penicillin or amoxicillin. If you are allergic, your doctor may prescribe a different antibiotic such as cephalexin or azithromycin. Remember a few things when you begin your antibiotics:[6]
    • Take the whole course of antibiotics, even when you feel better. Not taking the whole course can increase your chances of a recurrent and more serious infection, as the initial antibiotics may kill the weak bacteria, and the strong bacteria may survive and become resistant to the antibiotics taken. Do not skip doses. Regular antibiotics doses ensure that it works properly.
    • Try to avoid alcohol while taking antibiotics. While alcohol won't interfere with most antibiotics, it can intensify the side-effects, making you dizzy, drowsy, and giving you a stomach upset.[7] Be aware that some cough syrups and mouthwashes contain alcohol.
    • Take as directed. Talk to your pharmacist about how to take the antibiotic. Depending on the antibiotic prescribed, it may work better with or without food. For example, Penicillin V should be taken on an empty stomach, while amoxicillin can be taken with or without food. Most antibiotics are taken with a glass of water.
    • Look out for allergic reactions to antibiotics such as rash, swelling of the mouth, difficulty breathing or swallowing. If you experience any reaction, talk to your doctor and s/he can prescribe a different antibiotic. If you experience difficulty breathing call 911 as this can be a life threatening reaction called anaphylaxis.
    • Look out for side effects. Side effects of most antibiotics include upset stomach and diarrhea. There may be particular side effects to the antibiotic you are prescribed.
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    Take an OTC pain medication, such as acetaminophen or ibuprofen. This will help pain associated with the sore throat and other symptoms such as fever. Preferably, take the pain medication with food.[8]
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    Gargle with saltwater twice a day. This will help to ease the symptoms of strep throat. Mix about ¼ teaspoon of salt into a tall glass of warm water. Take the saltwater in the back of your mouth, lift your head back, and gargle for 30 seconds. Spit the salt water out after the back of your throat is coated.[9]
    • Drink plenty of fluids. Drinking warm, throat-soothing tonics such as lemon tea or tea with honey can help relieve the symptoms of strep throat. In addition, fluids and water keep you hydrated, which helps you to heal more efficiently.[10]
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    Use of a humidifier. A humidifier cycles dry air through moist air. This creates air that is easier and more soothing to breathe.[11]
    • If you don't have a humidifier handy, you can create a makeshift humidifier by bringing a pot of water to boil and letting it steam in a room you're inhabiting.
    • If using a humidifier, be careful not to overdo it. A little bit of moisture in your air is good. Too much moisture isn't. Too much moisture can help create perfect conditions for certain mold and fungus, aggravating symptoms, and possibly even delaying recuperation.
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    Take a lozenge. Throat lozenges or sprays are available over the counter at pharmacies and can help relieve sore throats. These may contain local anesthetics or antiseptics and offer symptomatic relief.
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    Contact your doctor if your symptoms continue. It is important to contact your doctor if your symptoms are do not improve within a few days (48 hours) or if symptoms worsen. This could mean your antibiotic is not working.
    • In addition, contact your doctor if you experience any side effects.

Part 3
Preventing Strep Throat

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    Stay at home for the first 24 to 48 hours. After you begin taking antibiotics, you will need to stay home for up to 48 hours to avoid spreading strep to someone else. A person is still infectious for the first 48 hours after beginning their course of antibiotics. Take care to avoid infectious contact with other people during this time.[12]
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    Throw away your toothbrush and get a new one. Do this after the first couple days of antibiotics, but before you finish your antibiotics. Otherwise, your old toothbrush could become a carrier and re-infect you once the antibiotics are done.
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    Avoid contact and don't share personal items. When possible avoid contact with people with strep throat, especially during the contagious period (up to 48 hours after starting treatment). If a family member has strep throat, don't share glasses or utensils.
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    Wash your hands. Proper hand washing is the best way to prevent all kinds of infections. According to the CDC proper hand washing technique includes:[13]
    • Wet your hands with clean, running water (warm or cold), turn off the tap, and apply soap.
    • Lather your hands by rubbing them together with the soap. Be sure to lather the backs of your hands, between your fingers, and under your nails.
    • Scrub your hands for at least 20 seconds. Need a timer? Hum the "Happy Birthday" song from beginning to end twice.
    • Rinse your hands well under clean, running water.
    • Dry your hands using a clean towel or air dry them.


  • Strep evaluation is very important because the strep bacteria can travel to other parts of the body, causing heart disease, infections of the blood, and kidney disease.
  • Strep can develop into and cause rheumatic fever which is very serious.
  • Once you started a course of antibiotics, you should start to feel much better within 24 hours. If this does not occur, call your doctor. You may have contracted a strain of bacteria resistant to the drug which your doctor prescribed for you. You should then return to the doctor for a new batch of medicine.

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Categories: Sore Throat Care