Streptococcal (strep) throat infection is very common. For many years, a 10-day course of oral penicillin was recommended for the cure of pharyngitis and pharyngotonsillitis caused by group A streptococcus. But a recent study suggests that newer antibiotics taken for shorter durations can effectively treat these conditions.
According to a Cochrane report from 2019, clinical trials on shorter treatment duration with oral penicillin for streptococcal pharyngotonsillitis are encouraged. Although it’s rare, a 10-day course of penicillin is prescribed mainly to protect against the complication of acute rheumatic fever, which can occur approximately 20 days after streptococcal throat and cause damage to the heart valves. But this approach may be changing on the heels of this newest study.
So, let’s take a look at what strep throat, how it’s treated, and how it’s treated.
There are generally more than 3 million cases of strep throat in the United States each year. It’s caused by a bacteria known as Streptococcus pyogenes, also known as group A streptococcus. It takes direct contact to spread the infection from person to person. Typically, someone coughs or sneezes. The infection is generally transmitted by direct contact with the mucus or sores of someone else with strep.
Common symptoms of strep throat include:
If you’re experiencing these symptoms, you should get in to see your doctor right away for a proper diagnosis.
Your doctor will typically perform a rapid strep test to determine if the strep bacteria are present. The test quickly shows if group A strep is causing the illness. If the test is positive, doctors can prescribe antibiotics. If the test is negative, but a doctor still suspects strep throat, then the doctor can take a throat culture swab.
If left untreated, complications from strep throat can involve the heart or kidneys.
Treatment is important to prevent complications. Oral antibiotics like penicillin, amoxicillin, cephalexin, or azithromycin are commonly used to treat strep throat. Other medicines such as acetaminophen or ibuprofen can help with pain and fever.
But when it comes to antibiotics, you can have too much of a good thing. It's called antibiotic resistance. Some bacteria can naturally resist certain kinds of antibiotics. Others can become resistant if their genes change or they get drug-resistant genes from other bacteria. The longer and more often antibiotics are used, the less effective they are against those bacteria.
The most commonly prescribed oral antibiotics for strep throat, in addition to penicillin, include:
Other medicines such as acetaminophen or ibuprofen can help with pain and fever.
One of the first things the study’s authors point out is that sore throat is a common reason for prescribing antibiotics. It accounts for about 11% of all antibiotic prescriptions in primary healthcare in Sweden, which is a low prescribing country. So, researchers compared the European standard regimen of 1000 mg penicillin V three times daily for 10 days with a course of 800 mg four times daily for 5 days.
They found that the number of relapses and complications did not differ between the two intervention groups. That means strep throat may still be treated with antibiotics, but a five-day treatment with penicillin V four times daily might be an alternative to the currently recommended 10-day regimen. The authors concluded that changing from 10 days to five days of treatment could substantially reduce the total consumption of penicillin V.
Staying ahead of your health is important. There are a lot of tests that can help you decrease your risk of many diseases and conditions. Our guide “Midlife Health Screenings for Men and Women” explains everything you need to know about these tests and the ages you should consider having them done.