How often do children complaining of a sore throat really have a strep throat? The signs commonly thought to indicate a strep throat -a red swollen throat with white spots - don't necessarily mean the child has an infection with group A streptococcus, the bacteria that causes a strep throat.
The strep culture, although considered to be the "gold standard" in testing for strep throat, is positive in only 30% of children with a sore throat. Half of the children with positive strep cultures really have a streptococcal infection of the throat. The other half are carriers - they have the strep in their throats all the time, but the bacteria frequently doesn't cause these kids any problems. Treating these children with antibiotics doesn't eradicate the strep - it just comes back again.
If the child is a carrier, their sore throat is most likely not caused by strep. If a throat culture is done on carriers when they are feeling well with no sore throat, it will be positive for strep.
If a rapid test or the clinical findings strongly suggest a strep throat, then treatment should be begun. If the throat culture doesn't confirm the diagnosis, then the treatment should be stopped.
When treating strep throat, penicillin and amoxicillin are the preferred antibiotics. Newer antibiotics are not recommended, Besides being more expensive, the newer antibiotics are no more effective and their use may lead increased bacterial resistance to them.
Family Practice News, 5/1/03
May not be reproduced in any format without written permission.
