Strep Throat
Also known as Streptococcal pharyngitis, Group A strep
This article is general health information for the selected condition. It is not a diagnosis and does not replace clinical judgement. If you have questions or need treatment advice, please consult a qualified healthcare professional.
What is strep throat?
Strep throat is a bacterial throat infection caused by group A Streptococcus. Most sore throats are viral, so distinguishing them matters to avoid unnecessary antibiotics. Treatment shortens illness slightly and, more importantly, reduces the risk of rheumatic fever, a serious complication affecting the heart.
Causes
- Group A Streptococcus bacteria
- Spread by respiratory droplets
- Close contact in households and schools
- Sharing food or drinks
Symptoms
- Sudden onset sore throat with painful swallowing
- Fever
- Swollen tender neck lymph nodes
- White patches or exudate on the tonsils
- Absence of cough, which helps distinguish it from viral illness
- Headache and abdominal pain, particularly in children
- Fine sandpaper rash in scarlet fever
Risk factors
- Age 5 to 15 years
- Close contact with an infected person
- Crowded settings such as schools and barracks
- Winter and early spring
Diagnosis
- Centor or FeverPAIN scoring to estimate likelihood
- Rapid antigen detection test
- Throat culture where testing is negative but suspicion remains
- Clinical distinction from viral pharyngitis and glandular fever
Treatment
- Penicillin V or amoxicillin for ten days
- Macrolides for penicillin allergy
- Analgesia and adequate fluids
- Completing the full antibiotic course to prevent rheumatic fever
- Return to school 24 hours after starting antibiotics
- Tonsillectomy considered only for frequent recurrent episodes
Self care
- Complete the full ten day antibiotic course
- Use paracetamol or ibuprofen for pain and fever
- Drink plenty of cool fluids and eat soft foods
- Gargle with warm salt water if old enough
- Rest until fever settles
- Replace your toothbrush after starting antibiotics
- Stay off school or work for 24 hours after antibiotics start
When to see a doctor
Book an appointment if:
- Severe sore throat with fever and no cough
- Symptoms not improving after 48 hours of antibiotics
- Difficulty swallowing fluids
- Recurrent episodes several times a year
- A rash developing with the sore throat
- Joint pain or dark urine in the weeks afterwards
Some symptoms need emergency care rather than an appointment. See the warning signs listed above.
Prevention
- Wash hands regularly and cover coughs
- Do not share cups, cutlery or food
- Stay home for 24 hours after starting antibiotics
- Replace toothbrushes after infection
- Treat cases promptly to limit household spread
Outlook
Strep throat improves rapidly with antibiotics, usually within a day or two, and resolves without treatment in most people over about a week. The reason for treating is preventing rheumatic fever and reducing spread, and this protection depends on completing the full course rather than stopping when symptoms ease.
Common questions
How can I tell strep from a viral sore throat?
Strep is more likely with sudden sore throat, fever, tender neck glands and tonsillar exudate, and notably without cough or runny nose. Cough and congestion point strongly toward a virus. Testing confirms it.
Why complete the full course?
The main reason for treating is preventing rheumatic fever, which can permanently damage heart valves. This protection depends on completing the full course, even after symptoms improve in a couple of days.
What is scarlet fever?
Strep throat accompanied by a fine red sandpaper textured rash and a strawberry tongue, caused by a toxin the bacteria produce. It is treated with the same antibiotics and is notifiable in many countries.
References
Important: Dard AI is not a medical device and does not diagnose, treat, or replace clinician judgement. This article is general information only. Always consult a qualified healthcare professional about diagnosis and treatment, and seek emergency care for severe or rapidly worsening symptoms.