Definition – Your child has a strep throat infection if diagnosis is confirmed by a throat culture or rapid strep test. The treatment of strep throat can prevent some rare but serious complications, namely, rheumatic fever (heart disease) or glomerulonephritis (kidney disease). In addition, treatment usually eliminates the fever and much of the sore throat within 24 hours.

Home Treatment – To reduce infection and rheumatic fever, make sure your child takes the antibiotic as directed. Do not stop the medicine early even if your child is feeling better. Change your child's toothbrush after the third day of medicine to prevent your child from getting reinfected from it.

A long-acting penicillin (Bicillin) injection can be given if your child refuses oral medicines or if it will be impossible for you to give the oral medicine regularly. (Note: If given correctly, the oral antibiotic works just as rapidly and effectively as a shot.)

Local Pain Relief – Children over age 1 can sip warm chicken broth or warm apple juice. Children over age 4 can suck on hard candy or lollipops. Children over age 6 can gargle with warm salt water (1/4 teaspoon of salt per glass).

Soft Diet – Since swollen tonsils can make some foods hard to swallow, provide your child with a soft diet for a few days.

Fever – Acetaminophen or ibuprofen may be given if your child has a fever over 102'F or a great deal of throat discomfort. (Do not give either of these medications if your child is under 2 months old. Do not give Ibuprofen if your child is under 6 months old.)

Contagiousness – Your child is no longer contagious after he or she has taken the antibiotic for 24 hours. Therefore your child can return to school after 1 day if the fever is gone.

Throat Cultures for the Family – Strep throat can spread to others in the family. Any child or adult who lives in your home and has a fever, sore throat, runny nose, headache, vomiting or sores; doesn't want to eat; or develops these symptoms in the next 5 days should be brought in for a throat culture. In most homes we need to culture only those who are sick. We will call you if any of these cultures are positive for strep infection.

Follow-up Visit – Repeat cultures are unnecessary if your child receives all of the antibiotic.

Call our office IMMEDIATELY if

  • Your child develops drooling.
  • Your child develops great difficulty with swallowing.
  • Your child is acting very sick.

Within 24 hours if

  • The fever lasts over 48 hours after starting an antibiotic.
  • You have other questions or concerns.

Written by Barton D. Schmitt, MD, pediatrician and author of Your Child's Health, Bantam Books, a book for parents.