Antibiotic Guide for Sore Throat - Simple Pharyngitis or Streptococcus (Strep Throat) Infection

A sore throat is also known as Pharyngitis. Pharyngitis and sore throat are used interchangeably when talking about a throat infection. Viruses, bacteria, and fungi may cause a sore throat. Strep throat is also known as GABHS (Group A Beta Hemolytic Streptococcus) which can also cause a sore throat. There are several common organisms that cause a throat infection. Antibiotic's are only effective against pharyngitis that is caused by a bacterial pathogen. Antibiotic's are chosen based on what the most likely invading bacterial organism or pathogen might be and severity of symptoms. If the symptoms are severe, testing and broad spectrum antibiotics may be indicated. Cost is always of taken into consideration when choosing antibiotics for the bacterial throat infection.There are several pathogens - organisms that may be the cause of a sore throat infection with most being caused by a virus. Bacterial pathogens do account for about ten percent of the invading organisms with a strong Gram - positive organism leading the list. A weak gram - negative pathogen may also be the cause of pharyngitis. A few of the common bacterial organisms that cause pharyngitis include H. influ, M. catt and Strep. Antibiotic treatment is based more on susceptibility to those narrow spectrum antibiotics that cover strong positive pathogens and weak negative organisms. Signs and symptoms of pharyngitis include cotton mouth, painful sore throat, tender lymph nodes at the neck region, tonsil ulcers with drainage, tonsil and pharynx redness, cough, congestion and possibly fever with malaise.There are many that argue the case of wait and see before prescribing antibiotics for an uncomplicated pharyngitis due to the high prevalence of the invading organism being a virus. There is nothing set in stone about a timeframe to start the medicine, but some say that if the sore throat continues past 72 hours antibiotic therapy should be started for the possibility of the pathogen being bacterial.Antibiotic Options based on the presenting symptoms and organism:If there are only minimal symptoms of a sore throat infection then a High Dose Penicillin or First Generation Macrolide Antibiotic is warranted and cost - effective to treat the infection.If pharyngitis symptoms are systemic such as with malaise and fever, then usually a stronger antibiotic is warranted in order to cover for a broad range of organisms that may be present. Systemic symptoms may indicate that the infection may be an atypical invading organism or strep. If there is the possibility of strep then a rapid strep test is indicated if cost is of no concern. If cost is a problem then treat with an antibiotic that covers for strep is appropriate. It is imperative that strep be treated and cured in order to prevent further complications associated with strep such as a sandpaper rash better known as a strep rash or scarlatina. A broader spectrum antibiotic is needed such as an Extended Penicillin, Second Generation Macrolide or Forth Generation Cephalosporin to cover for the possibility of strep throat infection.For those that are pregnant no antibiotic precautions are warranted as Penicillin, Cephalosporin and Macrolides are acceptable during pregnancy. The same holds true for children.If symptoms improve, no follow - up is usually indicated, even thought there is the option of a throat culture to make sure strep is not the cause of the infection. If symptoms persist or worsen then follow - up with a medical provider is warranted immediately.