I have a sore throat… should I go to the doctor?
A sore throat is one of the most common presenting complaints that we see during winter. Some sore throats require antibiotics, and some don’t. It is possible to get a throat infection (we call this “pharyngitis”) even if you no longer have your tonsils!
Most cases of sore throats are actually viral infections. In adults about 80% of sore throats are from a virus, and in children it is around 70%. These viral infections will resolve on their own, and we just need to support with pain management, which in many cases is just a good throat spray or lozenge. The rest are bacterial, and these are normally caused by a bacteria called Group A streptococcus.
Group A Strep will normal get better by itself within 5 days, but it is important to recognize and treat the bacterial infection, as Group A strep can result in Rheumatic fever, an abscess in the tonsil area and even a kidney problem. Treating with antibiotics with decrease the chances of developing rheumatic fever, but doesn’t necessarily decrease the chance of developing a kidney problem. It is not unreasonable that if your doctor is unsure if it is viral or bacterial, that they do a throat swab and wait for the results before giving antibiotics.
Group A strep is uncommon in children under the age of 3, and is most common in children age 5-10 during autumn and winter. There is an increased risk of having a bacterial throat infection if your child was exposed to another child who had it within the previous 2 weeks. The biggest problem is that children are normally infectious 2-5 days before they actually start getting sick, so the parents wouldn’t actually know that they should be keeping their child out of school.
It is not unreasonable to try symptomatic treatment at home before bringing your child to a doctor. The following symptoms suggest that the infection is viral:
-red eyes (conjunctivitis)
-cough
-hoarse voice
-runny nose or diarrhoea
If your child has a sore throat with the above symptoms, it is most likely a viral infection, and antibiotics are not necessary, and neither is a throat swab. If you are worried about their condition, you should see your GP anyway.
If they develop any of the following symptoms you need to see your doctor:
-fever
-white patches on the tonsils, throat or tongue
-swollen glands around the neck
-they are not coughing but complain of a sore throat
The antibiotic of choice for Group A Strep is penicillin, as the bacteria does not have penicillin resistance. There are alternatives if you or your child are allergic to penicillin.