Note when using antibiotics to treat strep throat

This is an automatically translated article.

The article was written by Pharmacist Duong Thanh Hai - Clinical Pharmacist - Faculty of Pharmacy - Vinmec Times City International Hospital
Worried about strep throat? Although pharyngitis is mainly caused by a virus and does not require the use of antibiotics, when strep throat is not treated properly with antibiotics, serious complications such as strep throat can occur. kidney or acute rheumatic fever (also called rheumatic heart disease). This article will give you information to keep in mind when using antibiotics in the treatment of strep throat.

1. Strep throat

Streptococcal pharyngitis is an infectious disease caused by a streptococcus strain, which can occur at any age, mainly in children, more often between the ages of 3 and 15 years old, less common in children. under 3 years old. Among the bacterial strains that cause sore throats, the most common causative agent is group A streptococcus Streptococcus pyogenes.
This bacteria lives in the nose and throat and can be spread easily from person to person through droplets from respiratory secretions. Streptococcal pharyngitis usually presents with symptoms of high fever, sore throat early on, pain when swallowing, swollen red tonsils with discharge, swollen lymph nodes in the neck.
In addition, some people may have other symptoms such as headache, abdominal pain, nausea or vomiting, especially children. Strep throat rarely causes cough, runny nose or diarrhea like viral pharyngitis. However, based on symptoms alone, it is often difficult to distinguish between viral pharyngitis or strep throat.

Therefore, in many cases, the doctor will check with a rapid diagnostic test with a throat swab to determine whether the cause is strep A or not. If the rapid test is negative, your doctor may do an additional culture test to look for strep bacteria, but this test takes about 3 to 5 days to get the results, and is usually done mainly on children.
This is a group at risk for complications of glomerulonephritis or acute rheumatic fever. When strep throat is diagnosed, to prevent these complications, the doctor will prescribe antibiotics for the patient.

2. What antibiotics are used to treat strep throat?

Some people can have strep throat but have no symptoms of a sore throat. These people are known by the term "carrier" - healthy people carrying the bacteria, usually do not need to use antibiotics because complications are rare and can be passed on to others.
However, when you have strep throat, using antibiotics will bring benefits including: reducing uncomfortable symptoms, shortening the duration of the illness, preventing the spread of bacteria to others, and preventing infection. More serious complications may occur such as abscess of the back of the throat, tonsillitis or acute rheumatic fever...
When choosing an antibiotic, the doctor will consider it based on factors of effectiveness. , the ability of antibiotics on streptococcal bacteria, safety, dosing schedule, cost and patient's drug adherence characteristics. The antibiotic of choice for strep throat is penicillin or amoxicillin. Amoxicillin is preferred due to its pleasant taste and better absorption.
In some cases where the patient is intolerant to these drugs (eg, allergic to penicillin), the doctor may substitute other options such as: clindamycin, azithromycin, clarithromycin or some cephalosporin antibiotics. . Most patients only need oral antibiotics. However, if the patient does not comply with the full course of antibiotics, the doctor may choose to use a single intramuscular dose of the antibiotic benzathine penicillin G.

3. What should be noted when using antibiotics to treat strep?

Penicillin, amoxicillin are effective antibiotics for strep throat. Usually, people feel better within a few days of taking antibiotics. If symptoms do not improve after 48 hours of antibiotics, the patient should notify the doctor to adjust the treatment regimen.
Occasionally, viral pharyngitis can occur in healthy people who carry the bacteria and antibiotics won't work. Conversely, when the patient responds well to antibiotics, the symptoms are relieved and the patient quickly recovers from the disease. But it is still necessary to continue using the antibiotic penicillin or amoxicillin for the full 10 days. Because, full 10 days of antibiotic treatment increases the ability to eliminate streptococci in the pharynx compared to a short course of 5-7 days. Therefore, patients should not arbitrarily stop antibiotics when their symptoms have improved.
Penicillin or amoxicillin antibiotics for strep are relatively safe antibiotics. However, any medication can cause unwanted side effects.
Although rare, people can experience an allergic reaction when taking the drug, with signs such as: itching, erythema, blisters or more severe signs such as swelling of the face, mouth, wheezing, difficulty breathing , difficulty swallowing and needing immediate medical attention. In addition, when taking antibiotics for a long time, it can cause mild gastrointestinal upset due to intestinal dysbiosis or severe diarrhea requiring hospitalization. At that time, the patient should inform the doctor about the antibiotic and how long to use it.

Streptococcal pharyngitis can occur more than once in a patient and there is no vaccine to prevent it. To protect themselves and prevent spreading the virus to others, sick people should rest at home for the first few days of illness until symptoms improve, wash hands often with soap, cover nose. mouth when coughing or sneezing. Use antibiotics at the right dose, for the number of times and for the duration of the course of treatment as prescribed by your doctor.
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