Strep throat
Strep throat is a common name of a pharyngitis caused by the bacteria Streptococcus. Honestly, I do not know even one person who did not have it at least once in a lifetime. That is how frequent it is.
Here is some statistics. Group A Streptococcus (GAS) is the most common bacterial etiology for acute pharyngitis and accounts for 5 to 15% of all adult cases and 20 to 30% of all pediatric visits to the clinic. It is rare to be hospitalized with Strep throat.
In this article:
- Treatment
- Antibiotics
- How long do I take them?
- Symptom relievers
- Essential oil for strep throat
- Strep throat recovery
- Lifestyle and home remedies
- References
Treatment
Strep throat is just one of the reasons for tonsillitis and pharyngitis. It is very important to get the right diagnosis before starting the treatment.
Antibiotics
Antibiotic therapyis indicated for patients with signs and symptoms of pharyngitis and laboratory confirmation of GAS as the causative pathogen. Strep A (GAS) resistance to penicillin has not been documented to date. Given its narrow spectrum, low cost, and efficacy in preventing resistance, penicillin is the drug of choice for treatment of GAS pharyngitis.
Amoxicillin is a more palatable suspension than penicillin V and is equally effective when used as a single daily dose (50 mg/kg, max 1000 mg) for 10 days. Penicillin G benzathine can be given as an intramuscular (IM) injection in a single dose if medication adherence is uncertain; however, the injection can be painful.
For patients with non-anaphylactic allergy to penicillin, a first-generation cephalosporin, such as cephalexin, is appropriate therapy. Clindamycin or a macrolide (e.g. azithromycin) can be used for treatment in patients with anaphylactic, or Type 1 hypersensitivity, to penicillin.
For children who experience a recurrence of laboratory confirmed GAS pharyngitis shortly after completion of antibiotic therapy, the same agent or an alternative agent such as a narrow spectrum cephalosporin, amoxicillin-clavulanate, or a macrolide may be used.
Laboratory confirmation of GAS isolate susceptibility should be considered when non-beta lactam agents are used since high resistance rates are reported in some geographic areas. Sulfonamides, tetracyclines, and fluoroquinolones should not be used for treatment of GAS pharyngitis.
How long do I take them?
It is extremely important to finish ALL course doctor prescribed to you treatment to prevent complications and antibiotic resistance.
Symptom relievers
NSAIDs (pain killers that are sold over the counter) such as ibuprofen, are very effective in reducing fever and pain for both children and adults with pharyngitis. You need to be careful not to exceed the daily dose due to liver toxicity. Here are few commonly used meds:
- Acetaminophen (such as Tylenol)
- Ibuprofen (such as Advil)
- Paracetamol
Although aspirin has also been shown to reduce pain in adults with upper respiratory tract infection, we recommend against the use of aspirin for pain relief of pharyngitis in children because of the risk of Reye syndrome.
Results from randomized, double-blind, placebo-controlled studies demonstrate that corticosteroids decrease the duration and severity of signs and symptoms in GAS pharyngitis in adults and children, although the actual decrease in pain duration is minimal
Essential oil for strep throat
Essential oils have been used in folk medicine for ages. Until recent their efficacy was criticized by conventional physicians. Now there are more and more publications finding that essential oils actually can help treat strep throat. Here is one of the studies done in the laboratory and published in Microb Pathog., 2018:
Essential oils from Origanum vulgare and Salvia officinalis exhibit antibacterial and anti-biofilm activities against Streptococcus pyogenes. Niluni M Wijesundara 1, H P Vasantha Rupasinghe
Abstract: In the present study, essential oils (EOs) extracted from oregano, sage, cloves, and ginger were evaluated for the phytochemical profile, antibacterial, and anti-biofilm activities against Streptococcus pyogenes.
The oregano and sage EOs showed the lowest MIC as well as MBC of 0.25-0.5 mg/mL. Time kill assay results showed that oregano and sage EOs exhibited bactericidal effects within 5 min and 4 h, respectively. Both oregano and sage extracts acts as a potent anti-biofilm agent with dual actions, preventing and eradicating the biofilm.
The microscopic visualization of biofilms treated with EOs have shown morphological and density changes compared to the untreated control. Oregano EO was constituted predominantly carvacrol (91.6%) and in sage EO, higher levels of α-thujone (28.5%) and camphor (16.6%) were revealed. EOs of oregano and sage inhibit the growth and biofilm formation of S. pyogenes.
Effective concentrations of oregano and sage EOs and their phytochemicals can be used in developing potential plant-derived antimicrobial agents in the management of streptococcal pharyngitis.
Strep throat recovery
A variety of topical agents have been marketed for therapy of acute pharyngitis. These include rinses, sprays, and lozenges. Several contain topical anesthetics, such as ambroxol, lidocaine, and benzocaine, that may give temporary symptomatic relief. Lozenges are effective, but are a choking hazard for young children. Here we list of of the best studies of a lozenge Strepticil, a randomized trial published in Int J Clin Pract. 2010
Rapid relief of acute sore throat with AMC/DCBA throat lozenges: randomized controlled trial. D McNally, M Simpson, C Morris, A Shephard, M Goulder:
Results: Amylmetacresol/DCBA throat lozenges reduced throat soreness at 5 min after first dose, which persisted for 2 h and was significantly different vs. non-medicated lozenges at all assessment timepoints for the duration of the 3-day study. Similar significant effects were observed with sore throat relief, easing of difficulty with swallowing and functional impairment scores.
Conclusions: Amylmetacresol/DCBA throat lozenges provide rapid analgesic effects that last for 2 h, providing ongoing relief long after the lozenge has dissolved. The superior analgesic effects and improvements in functional impairment scores observed with AMC/DCBA throat lozenges translate into pain relief benefits that are clinically meaningful and are thus a suitable OTC treatment option for patients in the self-management of acute sore throat.
Lifestyle and home remedies
It is important to offer a complete comfort and plenty of sleep to a child or adult with Strep Throat. A room should have enough sun and good air circulation. It is not a bad idea to use humidifier to provide moist air to a person with the throat pain. Essential oils can be used in a vaporizer for a better soothing effect.
Ice cream is a fantastic remedy – it helps with the pain in the throat, hydrates, provides calories for someone without appetite, and brings joy as it is delicious. I am sure that if someone would do the placebo-controlled study, an ice cream would be found very efficient in improving overall condition.
Home remedies are always used at home to help with the sore throat. One of the most popular is a black or green tea with honey and ginger or lemon. Many find a great relief while sipping on a hot or warm tea.
There are many home remedies that help to boost immune system, so the body will have more power to heal from infection faster:
- Manuka honey
- Chicken broth
- Vitamin C
- Vitamin D and sunlight
References
Guideline for the management of acute sore throat. ESCMID Sore Throat Guideline Group, Pelucchi C, Grigoryan L, Galeone C, Esposito S, Huovinen P, Little P, Verheij T.Clin Microbiol Infect. 2012 Apr;18 Suppl 1:1-28. doi: 10.1111/j.1469-0691.2012.03766.x.PMID: 22432746 Free article.
Strep Throat. Am Fam Physician. 2016 Jul 1;94(1):Online.PMID: 27386730 Free article.
Clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis: 2012 update by the Infectious Diseases Society of America. Shulman ST, Bisno AL, Clegg HW, Gerber MA, Kaplan EL, Lee G, Martin JM, Van Beneden C; Infectious Diseases Society of America.Clin Infect Dis. 2012 Nov 15;55(10):e86-102. doi: 10.1093/cid/cis629. Epub 2012 Sep 9.PMID: 22965026 Free PMC article.
Impact of Citral and Phloretin, Alone and in Combination, on Major Virulence Traits of Streptococcus pyogenes. Adil M, Baig MH, Rupasinghe HPV.Molecules. 2019 Nov 21;24(23):4237. doi: 10.3390/molecules24234237.PMID: 31766432 Free PMC article.
Herbal Tea for the Management of Pharyngitis: Inhibition of Streptococcus pyogenes Growth and Biofilm Formation by Herbal Infusions. Wijesundara NM, Rupasinghe HPV.Biomedicines. 2019 Aug 24;7(3):63. doi: 10.3390/biomedicines7030063.PMID: 31450579 Free PMC article.
Bactericidal and Anti-Biofilm Activity of Ethanol Extracts Derived from Selected Medicinal Plants against Streptococcus pyogenes. Wijesundara NM, Rupasinghe HPV.Molecules. 2019 Mar 24;24(6):1165. doi: 10.3390/molecules24061165.PMID: 30909644 Free PMC article.