Strep Throat Treatment

Strep throat (Group A Streptococcus) typically causes sudden throat pain, fever, swollen lymph nodes, and tonsillar exudate — without cough or runny nose. Viral pharyngitis usually includes cough, congestion, and hoarseness. Strep requires a throat swab for confirmation — clinical features alone are insufficient for diagnosis.

Yes — confirmed strep throat should be treated with antibiotics. Unlike viral infections, strep warrants antibiotic treatment not only to shorten illness duration and reduce contagiousness, but specifically to prevent rare but serious complications including rheumatic fever affecting the heart.

Without antibiotics, strep throat remains contagious for 2–3 weeks. With antibiotics, contagiousness typically ends within 24–48 hours — the standard recommendation for return to work or school. Completing the full antibiotic course is important even after symptoms improve.

Recurrent strep — typically defined as five or more episodes per year — warrants discussion of tonsillectomy, which significantly reduces strep frequency and severity in appropriate candidates. Household carrier evaluation and treatment may also be relevant if recurrence is frequent.

Penicillin and amoxicillin — the first-line antibiotics — commonly cause GI upset and can cause rash (particularly in patients with EBV mononucleosis). Completing the full course is important. Azithromycin is used in penicillin-allergic patients but resistance is increasing in some regions. Strep Throat visit What to expect from a Strep Throat visit