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Antibiotics are usually required to treat strep throat. While these are often not given until tests confirm the diagnosis of strep through, rapid stress tests allow the diagnosis to be made within minutes. Even without antibiotics, strep infection will clear on its own. However, antibiotics are necessary to kill the bacteria, limit the spread of infection and prevent medical complications. People who do not take antibiotics are contagious for a longer period of time and are at greater risk of developing serious complications related to the strep.

Antibiotics may be provided in pill, liquid or injectable form. Patients with strep throat should begin to feel better within a day or two of beginning antibiotic treatment. It is important to take the complete course of antibiotics prescribed, which usually lasts for 10 days to 14 days. Failure to take the entire course of treatment may increase the risk of serious medical complications (e.g., rheumatic fever, glomerulonephritis) or lead to development of antibiotic-resistant bacteria.

People with strep throat may continue to be contagious for at least 24 hours after beginning antibiotic treatment. They should not return to work or 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 patient. Patients who are not treated with antibiotics may be contagious for weeks after an infection.

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

Patients can manage symptoms by getting plenty of rest and nourishment. Adequate fluid intake (e.g., water, juice, broth) can help prevent dehydration. 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 self-treatment methods for strep throat include:

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

Patients are urged to avoid consuming 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, patients are urged to ask their physician about whether or not throat lozenges may help. Parents of children with strep throat are urged to remember that lozenges can pose a choking hazard for young children. Some lozenges may aggravate the symptoms of strep throat.

Although rare, a tonsillectomy is sometimes recommended for patients with repeated episodes of strep throat (e.g., more than five episodes in one year). Some studies suggest that strep throat infections occur much less often after a tonsillectomy. Patients are urged to consult their physician to weigh the benefits and risks of this type of surgery.

Patients should call their physician if they notice any of the following after completing their treatment:

• Cola-colored urine
• Fever
• Pain or swelling in the joints
• Rash
• Shortness of breath