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Infectious Diseases Infectious Disease Basics

A Scratchy Throat or Strep? Prescriptions Might Not be the Right Answer


Medical Reviewer:

Lorenzo Di Francesco, MD

Medically Reviewed On: September 14, 2006

Everyone has woken-up with a red scratchy throat that makes it difficult to swallow. As the day goes on, your symptoms get worse, but neither drops nor sprays will soothe the intense inferno that is raging in your throat. But is that sore throat a sign of a cold, strep throat or something else? And do you really need a prescription?

Between 1989 and 1999, 70 percent of adults who went to the doctor for a sore throat received an antibiotic prescription. While it's believed this prescription rate is declining, experts say that people are still receiving antibiotics unnecessarily. This may be because it is hard to tell who has the infection without doing a test or the fact many people have come to rely on prescriptions as a quick fix to their troubles. These are important issues for doctors and patients alike since antibiotic resistance diseases are on the rise, and finding and creating new medication is a long and difficult process.

To avoid future problems experts suggest entering into a partnership with your personal physician. This way each person plays a part in making sure antibiotics are used responsibly and will ensure people will have effective antibiotics for when they actually do have strep throat.

What causes sore throat?
Close to 80 percent of sore throats are caused by viruses. Unfortunately, if you fall into this category the best treatment involves the old stand-bys of rest and fluids since there is no magic bullet prescription that can alleviate your symptoms.

Antibiotics, like penicillin, are only effective on bacteria, like group A Streptococcus, that causes strep throat, and it is estimated to only cause about 10 to 20 percent of cases. The challenge for your doctor is to isolate that 10 to 20 percent so you don’t take an antibiotic needlessly.

In the case of adolescents it is also important to keep in mind your child’s sore throat symptoms might be a sign of Infectious mononucleosis (mono), which is can be spread through kissing, sharing drinks and utensils.

Signs and Symptoms
Often there isn't a real difference and the vast majority of people will have a combination of viral and strep symptoms. So it's very difficult to differentiate whether it's a virus or strep throat simply by examining people. But some of the telltale signs are:

Viral infection:

  • runny nose
  • swollen glands
  • cough
  • fever
Strep Throat:
  • a very severe sore throat with pus on the tonsils
  • swollen tonsils
  • swollen glands
  • no cough or runny nose
However, it turns out that maybe only 10 or 15 percent of people with strep are going to have strictly these types of symptoms.

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