By Tanya Remer Altmann, MD, FAAP
“Mommy, my throat hurts!” We’ve all heard this often–usually at 3 am, and the next stop is the pediatrician’s office.
Parents often look to antibiotics as a cure-all for whatever ails their child. Unfortunately, antibiotics are not the answer (and can even be harmful) for most sore throat illnesses. So before accepting that pink bubble gum-flavored medicine for your child’s sore throat, make sure it is a bacterial infection, not a viral infection.
There are two types of throat infections: bacterial and viral. Bacterial infections need treatment with antibiotics but viral infections don’t. Of the 47 million patients (adults included) who see their doctor for a sore throat each year, approximately 85% are viral and don’t benefit from antibiotic treatment.
How do you know if your child is one of the 15% that needs antibiotics to heal a sore throat? Unfortunately, you can’t tell on your own. In fact, even your pediatrician can’t tell the difference just by looking. Your doctor may have a clinical suspicion by the way your child’s throat looks and other symptoms (fever, cough, runny nose, etc.). But there’s only way to tell for sure — swab the throat and test the germs. Yes, the one that gags you.
This unpleasant test checks for the bacteria Group A Streptococcus, more commonly known as “Strep.” But you don’t have to wait 24 hours for the results anymore. There are several new quick tests for Strep that only take minutes in your doctor’s office. So now you can get the results before you head home.
If your child’s throat swab is positive for Strep, appropriate antibiotic treatment is needed to heal her quickly and prevent her from spreading the illness to others. More importantly, antibiotics prevent future complications (such as Rheumatic Fever). Therefore, make sure you give her the full course prescribed by your doctor, even if your child feels better after a few days. Also, Strep is very contagious, so don’t share food or drinks. And always remember to wash hands frequently. After 24-48 hours on antibiotics she won’t be contagious anymore and can return to school.
If the test is negative (not Strep) then treating this viral sore throat with antibiotics won’t help and CAN DO HARM. Overuse of antibiotics creates resistant organisms. This means the next time your child has a bacterial infection that requires antibiotics, the medicine might not work. That’s scary! There are already a few bacteria out there that are resistant to almost every antibiotic we have.
When antibiotics aren’t needed, which is most of the time, I usually recommend rest, fluids, throat lozenges, acetaminophen or ibuprofen (as directed) and every kid’s favorite — Popsicles! The pain should improve after a few days, although some viral illnesses can last for more than a week.
You can help your children by recognizing that medicine (even the yummy flavored ones) is not always the cure for illness. Before accepting antibiotics for your youngster’s next sore throat, make sure your doctor does a throat swab to test for the Strep bacteria. This will help your family stay healthy for many winters to come!