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Sore Throat

September 22, 2013

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When an infection makes you feel like you’ve been swallowing sandpaper, there are two types of germs potentially responsible: viruses and bacteria.

If you have a sore throat caused by a virus, you DO NOT need antibiotics. But if you have a strep throat, an antibiotic is necessary. Differentiating between a virus and a strep throat is not easy. Generally, viral sore throats co-exist with other symptoms, such as: a runny nose, red eyes, a cough, and a hoarse voice.

A strep throat is more likely if you suffer severe throat pain, a fever (temperature higher than 100.4°F or 38°C), and swollen glands in the neck.

In my practice, I use the modified Centor Score to estimate your probability of having a strep throat. I will then confirm or refute my provisional diagnosis based on the results of your throat swab. I will obtain a specimen by running a swab (Q-Tip) along the back of your throat. The sample is then sent away to be investigated.

In order to soothe a sore throat, gargle with salt water or take acetaminophen (Tylenol) or ibuprofen (Advil, Motrin). Do not give aspirin or medicines that contain aspirin to children younger than 18 years, as they can cause a serious problem (Reye syndrome). Also avoid throat sprays and cough drops in kids. Children who are older than 4 years, may get relief from sucking on hard candies or a lollipop. Older children (over 8 years) can find respite by gargling with salt water

If you have strep throat, wait one day after starting antibiotics before returning to school or work. I will usually prescribe a penicillin or a cephalosporin, unless you have a true penicillin allergy–in which case I will prescribe a macrolide-type antibiotic. Antibiotics decrease spread and duration of disease by about 1 day. Antibiotic use in the context of a strep throat reduces the rates of rheumatic fever, peritonsillar abscess, acute sinusitis, otitis media, and cervical lymphadenitis.

How can you prevent a sore throat?

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