If you have a sore throat and you go to the doctor in hopes of receiving a prescription for an antibiotic, you’re far from alone. Most people understand that over-the-counter cold remedies like cough syrups and cough drops treat the symptoms of a sore throat temporarily, while not actually curing the cause of the sore throat.
However, new guidelines from the Infectious Diseases Society of America (IDSA) say that prescription antibiotics are unnecessary for most types of sore throats, and that taking antibiotics for sore throat – even those prescribed by your doctor – may do more harm than good in the long run. The problem of antibiotic overuse is becoming more prevalent, as the Centers for Disease Control and Prevention now predicts that as many as 4 out of every 5 Americans receives a prescription for antibiotics every year. Some of these prescriptions might be unnecessary.
Why are Antibiotics Unnecessary for Most Sore Throats?
The answer is actually quite simple: the majority of sore throats result from viruses, not bacterial infections. While antibiotics are designed to fight bacterial infections, using them to fight viruses is like using vegetable oil to wash your clothes – it just doesn’t work. In short, antibiotics for sore throat are useless against viral infections.
The new IDSA guidelines state that antibiotics should be used to fight strep throat, and no other types of sore throats. This is because – you guessed it – strep throat is caused by a bacterial infection. Further, you shouldn’t assume that strep throat is responsible for a sore throat no matter your symptoms. Strep throat can only be confirmed through lab work conducted by your doctor, which generally involves a throat swab followed by diagnostic testing.
If you do test positive for strep throat, which results from a streptococcus bacteria infection, your doctor should write you a prescription for amoxicillin or penicillin. Antibiotics including cephalosporin (commonly called cephalexin) and azithromycin (offered under brand names Zithromax, Z-Pack and Zmax) are advised against by the IDSA because streptococcus bacteria is growing increasingly immune to them.
How Common are Sore Throats?
Roughly 15 million U.S. individuals visit their doctors with sore throats per year, and countless others suffer through them without a doctor’s visit. Roughly 70% of those who do visit their doctors with a sore throat receive an antibiotic, but only 5% to 15% of adults and 20% to 30% of children actually have strep throat. The rest are wasting their time and unnecessarily building up their immunity to antibiotics by taking antibiotic prescriptions.
Some of the symptoms of a viral throat infection, which is not strep throat, include:
-
Mouth sores
-
Hoarseness in speaking
-
Runny and/or stuffy nose
-
Cough
Individuals with these symptoms should rarely even be tested for strep, according to IDSA guidelines.
Some of the symptoms associated with strep throat include:
-
Pain when swallowing
-
Sudden throat pain
-
Fever
-
Lack of typical cold symptoms like runny nose and cough
Testing for Strep Throat
If you suspect you have strep throat, visit your doctor. The physician will likely use a rapid antigen detection test and have your results within minutes. Children and teens who receive negative test results should generally receive an additional throat culture just to be sure, though this is unnecessary for adults. Children under the age of three are rarely tested for strep throat because it’s extremely uncommon among this age group.
Some parents wonder whether tonsil removal is a wise idea for children with frequent throat infections. The IDSA recommends against this unless the child has difficulty breathing or other severe symptoms, as the risks of tonsil surgery generally outweigh the benefits.
Antibiotics for Sore Throat: The Bottom Line
Although antibiotics are frequently prescribed for sore throats, most sore throats are viral infections that cannot be improved through the use of antibiotics. The glaring exception is strep throat, a bacterial infection treatable with antibiotics like penicillin.
If you have a sore throat, particularly one that’s been ongoing for several days, it’s still a wise idea to visit your doctor for diagnostic testing.
The full text of the IDSA’s 2012 guidelines can be read in the online medical journal Clinical Infectious Diseases.
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