Strep throat is caused by group A streptococcus, a type of bacteria. It is a common cause of a sore throat, although most other causes are viral. This means it’s important to distinguish strep throat from other things that cause a sore throat. Otherwise, antibiotics may be used unnecessarily.
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Common strep throat symptoms are a sore throat, pain when swallowing, fever, red and swollen tonsils, red spots on the roof of the mouth, and swollen lymph nodes in the front of the neck.
Some people—especially children—also develop a headache and nausea. Typically, strep throat is not accompanied by a cough, runny nose, or vocal changes.
Testing is needed to definitively diagnose strep throat. Doctors typically use a rapid strep test to identify strep throat and prescribe antibiotics. Particularly with children, the doctor will double-check a negative test with a throat culture, which can catch infections the rapid test misses.
Adults don’t usually develop severe strep throat complications, so doctors don’t always use a throat culture with them. Children between five and 15, however, can develop rheumatic fever from untreated strep. Like adults, children under the age of three are at less risk.¹
This test is carried out by a doctor or in an urgent care clinic. Antibiotics can be prescribed immediately if the test result is positive.
Alternatively, you can sometimes test for strep throat at home. This involves taking a swab of your throat or your child’s throat using a test kit purchased at a pharmacy. The test kits come with full instructions for how to use them.
As a bacterial infection, strep throat is treated with antibiotics.
Penicillin or amoxicillin are typically used, as strep is not resistant to penicillin. However, your doctor may instead prescribe clindamycin, azithromycin, clarithromycin, or a narrow-spectrum cephalosporin such as cephalexin or cefadroxil if you are allergic to penicillin. Resistance to clarithromycin and/or azithromycin is known in some communities.
Treatment is usually a ten-day course. Don’t stop taking antibiotics until you have completed the course, even if you feel better. Stopping the course early could lead to antibiotic resistance.
You should stay home from work and children should stay home from school or daycare until you or they have taken antibiotics for at least 12 hours and no longer have a fever.
Drink plenty of water.
Some simple home remedies to ease sore throat symptoms include eating honey from a spoon, gargling with salt water, or drinking hot water with honey and lemon.
Tests used to diagnose strep are usually performed by a doctor. However, you can purchase rapid strep tests over the counter at a pharmacy without a doctor’s prescription.
Studies have shown that rapid antigen tests for strep throat carried out by a parent are no less effective than those administered by a doctor. However, a doctor will need to prescribe antibiotics if the test is positive.²
At-home tests allow strep throat to be diagnosed via telemedicine. This means you don’t have to go to the doctor’s office or take a sick child there, which may put others at risk.
Adults who have a negative test can generally take no further action. Even if you do have strep, it is likely mild and self-limiting.
However, if your child has a negative rapid test but has strep-like symptoms, a back up throat culture is needed.
Some doctors still require a face-to-face visit to prescribe antibiotics. Before using an at-home test, ensure your doctor is willing to prescribe antibiotics based on the result.
The test will provide results in about ten minutes.
Studies have shown that rapid tests for strep throat have a sensitivity (the ability to detect infected people) of 86% and a specificity (the ability to identify uninfected people) of 95%. Put simply, this means false negatives are more common than false positives. Being incorrectly diagnosed with strep and receiving unnecessary antibiotics is very unusual.³
Rapid tests can’t always distinguish a strep infection from simply having strep in your throat. About 10–15% of children are asymptomatic carriers, so they don’t need antibiotics.⁴
Home strep tests are similar to those used by a doctor and are just as accurate when performed correctly. Watch an instructional video or get advice from a medical professional via telehealth to ensure you are doing it correctly, whether you are trying to swab a child, yourself, or another adult.⁵
You can use a test on yourself, but consider it a part of the diagnostic process rather than a concrete diagnosis.
No. Throat cultures are not recommended for children under three or for adults. Strep is self-limiting in these groups.
Antibiotic treatment will reduce the length of the infection, ease symptoms, and reduce spread, but the overuse of antibiotics causes other problems.
Doctors can eliminate strep based on other symptoms. For example, strep does not cause a hoarse voice, cough, or runny nose. All of these indicate the sore throat has a viral origin, such as a cold.
Parents might buy and use at-home strep tests despite clear indications that the individual doesn’t have strep. This wastes time and delays a diagnosis.
You can typically purchase at-home strep tests from drug stores. They are labeled as “Strep A throat test,” “Strep A swab test,” or similar. Many drug stores also offer on-site strep testing conducted by a nurse, which can be easier than going to a doctor’s office. You can immediately get a prescription if needed.
At-home strep tests are generally more affordable than a doctor’s visit, but try to ensure that you won’t need to see your doctor anyway.
You can also order at-home strep tests online. Order from a pharmacy or another reputable source to be sure you are getting a good test.
Stay home from work until you no longer have a fever and have been taking antibiotics for at least 12 hours. Keep children home from school and daycare. This helps ensure that you or they are not contagious and will not pass strep to others.
Strep is easily transmitted when people talk, cough, or sneeze, or if you come into contact with infected sores from scarlet fever. You can also get sick by touching your mouth after touching surfaces contaminated with infected droplets. Drinking from the same glass or eating from the same plate as someone with strep may cause you to get it yourself.
Avoiding these activities can reduce your risk of catching or spreading multiple germs.
You can also use home remedies, including the following:
Resting as much as possible
Drinking hot water mixed with lemon juice or apple cider vinegar and a teaspoon of honey
Gargling with salt water, which reduces swelling in the throat
Eating chicken soup, especially with a bit of added garlic. Chicken soup tends to make you feel better in general and can help soothe your sore throat.
Taking a non-steroidal anti-inflammatory drug (NSAID) to reduce pain
Taking throat lozenges
These remedies can help ease your sore throat symptoms, but they won’t cure your strep throat.
At-home rapid strep tests are as effective as those administered in a doctor’s office, as long as you administer them correctly. Testing at home could enable you to avoid a doctor’s visit.
You can purchase at-home tests from a pharmacy in person or online.
Call your doctor’s office before using an at-home test. Ask if they will prescribe antibiotics based on your test result or if they will make you come in anyway.
At-home strep tests are not 100% accurate. Your doctor may recommend a back up throat culture if your result is negative.
While antibiotics can treat strep throat and prevent potentially dangerous complications in children, they are not recommended for asymptomatic carriers. However, at-home tests can help you avoid a doctor’s visit and reduce the spread.
Rheumatic fever: All you need to know | Centers for Disease Control and Prevention
Rapid streptococcal antigen detection test performed by parents of children with sore throat | Society for Participatory Medicine
Home strep test could save time and money | Massachusettes Institute of Technology