Strep Throat: Myths & Facts Parents Should Know

Strep throat is one of the most common infections this time of the year. We want to share some myths and facts every parent should know about strep infection this school year.

First, let’s begin with what it is strep throat?

Strep throat is a throat infection caused by group A beta hemolytic streptococcus (GAS). While this infection can be very contagious, particularly in a school setting, it also more common in kids of a specific age group.

Our Pediatric Urgent Care clinics also see children who have a cold, sinusitis, bronchitis, pink eye and urinary tract infections (UTI).

MYTH 1
Infants & toddlers don’t get strep throat.

ANSWER: YES & NO

“Classic” strep throat is very uncommon in infants and toddlers. Children age 3 and younger usually don’t complain or can’t complain of a sore throat when they have a strep infection. They typically have uncharacteristic symptoms, such as prolonged nasal congestion, yellowish nasal discharge, low-grade fever, fussiness, decreased appetite and tender neck glands. Some may have redness around the anal opening, which may be painful. They often have a history of exposure to older children with GAS pharyngitis.

MYTH 2

Strep can be diagnosed via telemedicine or without testing.

ANSWER: NO

Strep accounts for 15% to 30% of all cases of sore throat in children between the ages of 5 and 15. Most cases are due to viral infections and don’t require antibiotic treatment.

Recent evidence suggests an increase in antibiotic prescription and use in those cared for via telemedicine.

MYTH 3

Everyone with sore throat needs to be on antibiotics.

ANSWER: NO

Testing to confirm that the infection is strep throat before prescribing antibiotics helps prevent the unnecessary use of antibiotics in children. We recommend a throat culture for those who have a negative rapid test if strep throat is highly suspected.

Antibiotics are essential for treating bacterial infections like strep throat but can have their own risks.
Some risks include diarrhea, yeast infections, allergic reactions and antibiotic resistance. It is therefore essential to know when antibiotics are necessary for sore throat and when they are not.

Pediatrix Urgent Care serves patients from newborn up to 21 years of age. Patients between 18 and 21 years of age can be seen without a parent or guardian being present. Reserve a Spot Today!

MYTH 4

All children with a positive strep test and cold symptoms need to be treated with antibiotics.

ANSWER: NO

It is best not to test for strep in children who have a cold or viral symptom such as a runny nose, cough and mouth sores because this may result in a false-positive test.

Between 5% and 21% of children between age 3 and age 15 are carriers of strep. These children will test positive even when they have no symptoms. Neither throat culture nor rapid test for strep can differentiate patients with acute strep throat and those who are just carriers. Such patients may fail to respond to antibiotic treatment for strep infection. Clinical judgment may be needed in children who have underlying allergic rhinitis, chickenpox or altered immunity.

MYTH 5

Strep throat can be recurrent or persistent.

ANSWER: YES

Persistent infection occurs when symptoms caused by strep are not resolved after appropriate antibiotic treatment. This may be due to incomplete treatment or treatment failure. Recurrent infection can be caused by the same strep strain that caused the initial infection or by a different strain.

Recurrent infections most often occur among members of the same household or in other settings such as schools or daycare centers where close contact facilitates strep transmission.

Why is Strep Throat Treated?

Many children and adolescents with strep throat will get better in a few days, even without antibiotic treatment. However, treatment is recommended to speed up the resolution of symptoms and to decrease the risk of transmitting the infection to others.

Prompt treatment also decreases the risk of other complications resulting from an immune reaction to bacteria such as acute rheumatic fever, kidney disease and pediatric autoimmune neuropsychiatric disorder associated (PANDAS). Treatment also decreases the risk of the bacteria being spread to other parts of the body or causing a local abscess (peritonsillar abscess).

Short delays in therapy while awaiting culture results have not been associated with increased rates of complications such as acute rheumatic fever.

Which Antibiotics Work Best For Strep Throat?

Group A strep is highly sensitive to penicillin. Most providers prescribe Amoxicillin for 10 days because it is more readily available and better tasting than oral penicillin. The course of antibiotics must be completed to decrease the possibility of treatment failure.

One injection of long-acting penicillin (Bicillin LA) is an option for those suspected to be non-adherent or those who without access to refrigeration. Most providers do not keep Bicillin in stock because it is expensive and infrequently used.

Alternative antibiotics will be used for those allergic to penicillin, travelers or in those with persistent or recurrent infection. Cephalosporins (Cephalexin, Cefdinir), clindamycin and macrolides (Zithromax) are alternatives for patients who are allergic to penicillin or who cannot otherwise tolerate penicillin.

Pediatrix Urgent Care can evaluate and determine the appropriate treatment for sore throat.