Everyone has woken-up with a red scratchy throat that makes it difficult to swallow. As the day goes on, your symptoms get worse, but neither drops nor sprays will soothe the intense inferno that is raging in your throat. But is that sore throat a sign of a cold, strep throat or something else? And do you really need a prescription?
Between 1989 and 1999, 70 percent of adults who went to the doctor for a sore throat received an antibiotic prescription. While it's believed this prescription rate is declining, experts say that people are still receiving antibiotics unnecessarily. This may be because it is hard to tell who has the infection without doing a test or the fact many people have come to rely on prescriptions as a quick fix to their troubles. These are important issues for doctors and patients alike since antibiotic resistance diseases are on the rise, and finding and creating new medication is a long and difficult process.
To avoid future problems experts suggest entering into a partnership with your personal physician. This way each person plays a part in making sure antibiotics are used responsibly and will ensure people will have effective antibiotics for when they actually do have strep throat.
What causes sore throat?
Close to 80 percent of sore throats are caused by viruses. Unfortunately, if you fall into this category the best treatment involves the old stand-bys of rest and fluids since there is no magic bullet prescription that can alleviate your symptoms.
Antibiotics, like penicillin, are only effective on bacteria, like group A Streptococcus, that causes strep throat, and it is estimated to only cause about 10 to 20 percent of cases. The challenge for your doctor is to isolate that 10 to 20 percent so you don't take an antibiotic needlessly.
In the case of adolescents it is also important to keep in mind your child's sore throat symptoms might be a sign of Infectious mononucleosis (mono), which is can be spread through kissing, sharing drinks and utensils.
Signs and Symptoms
Often there isn't a real difference and the vast majority of people will have a combination of viral and strep symptoms. So it's very difficult to differentiate whether it's a virus or strep throat simply by examining people. But some of the telltale signs are:
Viral infection:
- runny nose
- swollen glands
- cough
- fever
Strep Throat:
- a very severe sore throat with pus on the tonsils
- swollen tonsils
- swollen glands
- no cough or runny nose
However, it turns out that maybe only 10 or 15 percent of people with strep are going to have strictly these types of symptoms.
Health
How do you test for strep throat?
The gold standard for testing for strep throat is a throat culture. Your doctor might also perform rapid strep test. Both are done by swabbing the tonsils and the back of your throat. However, in a throat culture, the organism is grown in a laboratory in order to positively identify that the infection is caused by the strep bacteria. Results usually take between 24 to 48 hours.
Rapid strep tests are used to confirm group A strep bacteria by testing for proteins the bacteria makes. It can produce results in just a few minutes, but is not as reliable because it does not detect other kinds of bacteria that maybe causing the infection. However, most experts would recommend that children with suspicious cases and a negative rapid strep undergo a throat culture to confirm what is causing the infection.
What are the consequences of not treating strep?
What's not widely known is that the main reason that strep throat is treated with antibiotics is to prevent a complication called rheumatic fever, an autoimmune complication to the bacteria. Rheumatic fever is a serious infection that can damage the heart, and if left untreated can lead to heart failure. Onset usually occurs about 2-4 weeks after a strep throat infection but luckily cases have sharply declined from the 1950s since introduction of antibiotics.
How long should someone wait before they go to the doctor to get tested?
One study showed that about 80 percent of people didn't go to the doctor when in fact they did have a viral sore throat or a respiratory infection. This is because most people will rationalize their symptoms as a cold. If you have a mild sore throat with a runny nose, cough, perhaps with some muscle aches, and no fever, you can generally wait a few days to see if the symptoms get better.
However, a doctor should be consulted when a child between the ages of 5 to 11 has a lingering or intense sore throat because strep is more common in that age group or when an adult experiences a sore throat with a fever and/or skin rash, which may indicate scarlet fever, another type of bacterial infection.
Also if you're uncertain about what is causing your sore throat, then that's a good time to see a doctor. When you go don't be surprised if he or she doesn't prescribe you an antibiotic because most likely it's a virus. Again, it's important not to take the antibiotics to minimize the chance that you're going to have greater problems with antibiotic resistance. However, if an antibiotic is prescribed, you need to make sure you complete the entire amount because experts know that not taking a full course of antibiotic therapy can also contribute to making bacteria more resistant.
What is the downside of using antibiotics for viral infections?
Using antibiotics for viral infections does not help and in fact increases levels of antibiotic resistance and the risk for an adverse drug reaction. It seems clear that, when you take the antibiotics for your viral sore throat, there are other bacteria present in your body that become resistant to antibiotics, and may lead to possible problems down the road.
