Why do we treat strep throat with antibiotics?

Uncategorized Jan 13, 2023

 So, why do we treat strep throat with antibiotics?

There are two main complications of strep throat that can occur if the throat
infection is not treated with antibiotics. First, a little background.

There are at least 50+ strains of group A strep bacteria.  

  • Two strains (M3 and M18) can cause a heart condition called rheumatic fever.  
  • Four strains (M 1, 2, 4 and 12) can cause a kidney disease called post-streptococcal glomerulonephritis.
  • Only 6 out of 50 strains (12%) cause these illnesses, BUT we can't detect
    which strain is causing the sore throat with our regular testing.
  • So... because 12% is A LOT of patients for a pediatrician - 12 out of every 100 strep throat cases! - we give antibiotics to prevent these serious complications. 
  • And oh by the way, your child well feel like million bucks in 24 to 48 hrs and can get back to the fun stuff of life.

Another potential complication of strep (and other bacteria & viruses) is Pediatric Autoimmune Neuropsychiatric Syndrome (PANS, formerly PANDAS), which causes sudden new onset OCD and/or Anxiety and a variety of other symptoms in children. 

PANS is still being debated in the mainstream medical community, but integrative pediatricians like us have acknowledged the good science and have treated it with successful protocols for years. 

Sounds like another blog could be bubbling up...

What's the best antibiotic for strep? 

Short answer: Penicillin-based antibiotics like amoxicillin.

It's still rare for Group A Strep to be resistant to amoxicillin, thank goodness.

If your child is allergic to amoxicillin, Keflex and Zithromax work well too.

After 24 hours of taking antibiotics for strep throat, we are not contagious anymore. Can I get a hallelujah for back to play & school?!

The problem is, you've got to make sure (insert child's name) takes the whole course of antibiotics, even though they feel so great they absolutely don't want it anymore. 

Time for the seat belt boundary and follow-through mindset. We don't want our child injured in an accident, so we have a seat belt rule & make sure we all "buckle up for safety".

In the same way, we also don't want our child to have the strep complications above, remain sick & miserable -or- develop resistant strep bacteria - SO we calmly stick to the plan. Arguing children are acknowledged - "I hear that you don't feel like taking this anymore. It's a bummer." - and the follow through still happens. Focusing on the fun that comes after the medicine works wonders. 

Lastly, do the body a HUGE favor.

Give probiotics in between the antibiotic doses (2-3 hours before or after) and every day for a month afterwards. Make sure they're good quality with several different strains on the ingredient list. Refrigerated tends to be best.

Since antibiotics don't play favorites, they kill a lot of our 'good guy' bacteria too. We REALLY need those probiotics to stay healthy - supposed to be 80-20 in favor of the good guys for the best health. So don't forget - set a reminder alarm and build those guys back up!

  ***We are doctors, but we are NOT YOUR doctors. Information included here is for educational purposes only and should NOT be construed as medical advice. Please call YOUR child's doctor for further guidance.***

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