Sore Throats

Sore throat (also called pharygitis or tonsillitis) is one of the most common infections that send children to the doctor. It is seen in all age groups and occurs throughout the entire year. Sore throats can be caused by either a virus or bacteria, but the majority of cases are caused by a virus. Only 20% to 30% are caused by bacteria and require antibiotics. The most important bacteria to cause a sore throat is Group A beta hemolytic streptococcus, commonly called “strep throat”.

Certain symptoms point to a viral cause for the sore throat, such as cough, runny nose, hoarseness and mouth ulcers. Both viral and bacterial causes for sore throat can cause fever.

The most important reason to treat strep throat is to prevent acute rheumatic fever and associated rheumatic heart disease; but also to hasten recovery, to improve the well-being of the patient and to decrease the spread of infection to others.

A quick test for strep is the Rapid Strep Test and is performed using a special Q-tip to swab each side of the throat/tonsils and the back wall of the throat. This test is simple and if positive is very reliable in identifying the strep bacteria. However, the reliability of a negative test is not as good; therefore, that test should be followed up by a strep throat culture sent to the lab. 

It is NOT possible or judicious to clinically diagnose strep throat “just by looking and finding a red throat”. This leads to a significant number of antibiotics given for viral infections; is a misuse of antibiotics; and leads to antibiotic-resistant organisms which can be harmful to the patient and everyone else on the planet!

Any child who has a sore throat is a potential candidate for a rapid strep test. However, if the symptoms clearly point to a viral cause for the sore throat, that child should not be swabbed. Also, the age of the child is important as children less than three years of age have a low incidence of strep throat and rheumatic fever, and should only be tested if there is an older sibling or parent in the family who currently is being treated for strep throat.

Treatments for viral and bacterial causes of sore throat are aimed at decreasing the discomfort of the patient using fever reducers/pain relief medicines such as acetaminophen or ibuprofen. Older children can use throat lozenges to help numb the pain of the tissues of the throat.

Antibiotics will not help AT ALL for viral causes of sore throat and should not be used. But strep throat should be treated with an appropriate antibiotic at an appropriate dose for an appropriate amount of time. Penicillin or amoxicillin are recommended as the drugs of choice since they are low in cost, have infrequent side effects and work efficiently to kill the strep bacteria. For persons allergic to penicillin, a first generation cephalosporin like Keflex is in ideal drug. These three antibiotics are given for 10 days, NOT just until the child is better. Another alternative is a 5-day course of azithromycin.

For more information please contact AfterHours Pediatrics at (561) 963-4874 open everyday.