If my child has a sore throat, will they need antibiotics?

Pharyngitis, commonly known as a sore throat, is one of the leading causes for children’s visits to pediatrician.  The cause of a sore throat is most commonly due to a virus.  This virus is oftentimes the same as those that cause a common cold and will show with typical cold symptoms (fever, cough, runny nose) along with a sore throat.

While most cases of sore throats are caused by viruses and are self-limited, meaning that they will heal on their own with the body’s natural defenses.  There are also cases of sore throat caused by bacteria which can be treated with antibiotics.

A commonly known term, strep throat, is an infection in the back of mouth/tonsils caused by the bacteria Group A Streptococcus.  This type of throat infection has the potential, albeit rare, for serious complications affecting the heart, kidneys, brain, or joints. The risks for serious side effects can be significantly reduced with the use of antibiotics.

Antibiotics should only be prescribed to confirmed cases of strep throat or in cases of highly suspected bacterial cause for the pharyngitis.

Symptoms of sore throat can include:

  • Pain with swallowing
  • Enlarged tonsils
  • Headache
  • Vomiting/Abdominal Pain
  • Fever
  • Redness in back of mouth
  • Swollen lymph nodes in the neck
  • Rash

Who gets strep throat?

Sore throats caused by Group A Streptococcusbacteria are most common between ages 5-15 years of age.  Fortunately, strep throat is uncommon before 3 years old and the complications of strep throat are very rare in children under 2-3 years old.

How is strep throat diagnosed?

Strep throat needs to be diagnosed based on history and doctor’s exam findings, often along with laboratory tests.  These tests typically include a swab of the tonsils/back of the throat for streptococcus bacteria.  One test, often referred to as a “rapid strep” test, can produce results in only a few minutes.  This aids in diagnosing an infection that requires antibiotics.

The American Academy of Pediatrics & IDSA state that testing is not routinely recommended for children less than 3 years old, due to low incidence of strep throat & rarity of complications. Certain children under 3 years old with symptoms of sore throat should be tested for strep throat, such as those with a sibling who have a confirmed case of strep throat.

How is sore throat treated?

Confirmed cases of sore throat caused by Group A Streptococcus bacteria should be treated with antibiotics, typically penicillin or amoxicillin.   The amount of the medication will be determined based on your child’s weight and it is imperative for them to complete the full course of treatment prescribed unless otherwise instructed by your pediatrician. Viral causes of sore throats unfortunately cannot be killed by antibiotics or other medications and will improve with the natural defenses of the body.

Treatments aimed at improving the symptoms of sore throat can be used to help make a child more comfortable, such as an anti-fever medication like acetaminophen (Tylenol®) or ibuprofen.  Other over-the-counter throat pain relief products, such as throat sprays and lozenges, also exist and can aid in relieving the symptoms of a sore throat.

One treatment which was likely recommended by your mother or grandmother is gargling with warm salt water. If a child is able to gargle, this treatment does help to provide some relief as well as helping to eliminate the infectious agent. Tea with honey & lemon and chicken soup (Yes, your grandmother was right again!) also can help to provide relief to a sore throat.

Prior to starting any treatment, even if it is over-the-counter, discuss it with your pediatrician. For more information on pharyngitis, please consult with your pediatrician.

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