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Antibiotics are required to treat strep throat in children, even though the infection usually clears within a week. Antibiotics are necessary to kill the bacteria, limit the spread of infection and prevent medical complications.

Antibiotics may be provided in pill, liquid or injectable form. Children with strep throat should begin to feel better - and parents will typically notice a reduction of symptoms - within a day or two of beginning antibiotic treatment. Parents should ensure their child takes the complete course of antibiotics prescribed. Failure to be treated with antibiotics, or failure to take the entire course of treatment, may increase the risk of serious medical complications (e.g., rheumatic fever, glomerulonephritis). Failure to complete treatment may also lead to the development of antibiotic-resistant bacteria.

Children with strep throat may continue to be contagious for at least one day after beginning antibiotic treatment. Children should not return to school until they have taken antibiotics for at least one day, the fever is gone and they feel better. Antibiotic treatment limits the spread of infection but does not prevent strep throat from recurring in a particular child. Children who are not treated with antibiotics may be contagious for weeks after an infection.

If a child who has tested positive for strep throat does not respond to antibiotic treatment, it may be because that child is a carrier (carries the bacteria in the body but never develops an infection). The existing condition may also not be strep throat at all, but a viral infection. A way to confirm this is to test the child for strep throat when signs of infection are no longer present. A healthy, asymptomatic child who tests positive for strep throat is considered a carrier. It is not usually necessary to treat carriers.

Parents of children with strep throat can help manage their child’s symptoms. This includes ensuring the child gets plenty of rest and nourishment. Adequate fluid intake (e.g., water, juice, broth) can help prevent dehydration that can occur when children are sick. In addition, certain over-the-counter pain medications (e.g., acetaminophen, ibuprofen) can help reduce the fever and pain associated with strep throat. Parents should never give aspirin to children or adolescents since it may increase the risk of Reye syndrome, a potentially fatal condition.

Additional methods that may comfort a child with strep throat include:

• Gargle with warm salt water
• Drink cool or warm liquids
• Eat soft foods (e.g., soup, popsicles)

Parents should avoid giving the child acidic products (e.g., orange juice, lemonade), since they may sting the throat. Environments that include cigarette smoke or fumes from paint or cleaning products should also be avoided, since these may irritate an already sore throat. In addition, parents should consult their child’s pediatrician about whether throat lozenges or throat sprays may help. Lozenges can pose a choking hazard for young children, and some lozenges may aggravate the symptoms of strep throat. Throat sprays are sometimes recommended for symptomatic relief in children 6 years and older.

Although rare, a tonsillectomy is sometimes recommended for children with repeated episodes of strep throat (e.g., more than five episodes in one year). Parents should consult their child’s pediatrician to weigh the benefits and risks of this type of surgery.