At one time, doctors automatically treated all sore throats with antibiotics, both to cure the infection and to prevent dangerous complications such as rheumatic fever. Now, doctors are much less likely to prescribe medication because the overuse of antibiotics has led to an increase in antibiotic-resistant strains of bacteria. What’s more, antibiotics such as penicillin do little to hasten recovery from strep throat or to reduce signs and symptoms, and they don’t prevent infections from recurring. Be sure your doctor performs a rapid strep test before prescribing any antibiotic for a sore throat.
If your sore throat is caused by Streptococcus, your family doctor will probably prescribe penicillin, taken by mouth for 10 days. Another antibiotic, called erythromycin, can be used if you’re allergic to penicillin. If your sore throat is caused by different bacteria, your doctor may prescribe another type of antibiotic.
Warm or cool mist may help you feel more comfortable by soothing the swollen air passages. It may also relieve hoarseness. However, don’t let your room become uncomfortably cold or very damp.
Use a shallow pan of water to provide moisture in the air through evaporation if you don’t have a humidifier. Place the pan in a safe location where no one will trip on it or fall into it.
Aspirin gargles may ease the soreness. (There is little research evidence that confirms this. However, it is a popular treatment and may be worth a try.) Dissolve some soluble aspirin in water and gargle for 3-4 minutes. You can do this 3-4 times a day. Spit out the aspirin after gargling.
Contact your doctor if your sore throat persists for more than three days or if you have any other concerns. You may have a bacterial infection and benefit from antibiotic or other treatment. Also, if you have an accompanying earache, call your doctor. See a doctor immediately if the sore throat symptoms suddenly cause your voice to change to what is called “a hot potato” voice. This muffled tone sounds as if you have hot French fries in your mouth and cannot fully enunciate.
Others swear by gargling with chili pepper (yes, chili pepper!) Capsaicin, the ingredient in chili pepper that makes them hot, also numbs the throat. Mix ½ tsp. dried chili or cayenne pepper in a few ounces of water and gargle. Just like mom used to say, gargle with salt water (½ tsp. mixed with 4 oz warm water) every few hours or as needed.
If antibiotics are used, a 10-day course of oral penicillin (or a single dose of intramuscular benzathine penicillin G) is still the treatment of choice for GAS pharyngitis, because of its proven efficacy in eradicating the organism and preventing subsequent rheumatic fever, its safety, narrow spectrum and low cost. Twice-daily dosing (250 mg of phenoxymethyl penicillin in children, 500 mg in adults) is as effective as three- or four-times-daily dosing and is now the preferred regimen. Regimens using broader-spectrum antibiotics have comparable bacteriological and clinical cure rates with shorter courses, but are not recommended, as they promote resistance, are more expensive and have more side effects, particularly gastrointestinal.
Avoiding close contact with ill people can help you from getting a throat infection. Cold viruses appear to be more readily transmitted than streptococcal infections. Only about 25% of family members exposed to strep develop strep throat. Usually a person with strep throat becomes noninfectious within 24 hours after the first antibiotic dose. The incubation period (the time between exposure to strep germs and onset of illness) is usually 2-5 days. Children should stay home from school and day care during infectious periods.
