Wednesday, October 30, 2019

Strep Throat--Are Antibiotics Really Needed?

Disclaimer.  I am not a licensed health practitioner.  This is just another post on knowledge and understanding you might wish to acquire in advance of a disaster in case no higher care is available.  As long as our society is functioning, you should leave anything more substantial than applying a Band-Aid to the professionals.  No medication, including those available over the counter, should be taken without consulting a physician.  Information shared here is for educational and entertainment purposes only.  It is not medical advice nor a substitute for licensed medical care. 


Why does the mere thought of strep throat scare parents? It's a phenomenon that doctors everywhere observe, but parents can't usually articulate what they're afraid of. Shouldn't we be more concerned about measles, diphtheria, or cholera? Definitely, but maybe it's that strep throat is something we can relate to. It really hurts, and you know your child is really in pain.

I've got good news for you. You can be every bit as good as the best family doctor just by looking at your child's sore throat. The bad news is that even the best pediatricians are only right half the time.

More good news is that your child has a 99.9% chance of recovering completely without any antibiotics at all.

But what about rheumatic fever? (Maybe that's what we parents are afraid of when our child has strep.)  In the United States, less than one in one thousand cases of strep throat go on to develop into rheumatic fever. So does it make sense to use a precious supply of antibiotics on a presumed strep throat? Remember, without a lab test, you won't even be sure it's strep. Yes, it is a bacterial infection, but one of those infections that most people get over without antibiotics. Again, do you want to use your antibiotics that can be used to save a life on an illness that will pass and that is not anywhere near life-threatening? It's easy to be strong now and say your child will do without; it's a lot harder when your five-year-old has a burning fever and is in great pain.

So maybe you can dig a little deeper into determining whether it is, in fact, strep throat. One thing you can do now is a bit on the expensive side, but if you have a young and/or large family, it may be worth it. You can get rapid strep test kits on Amazon for about $25 (includes 25 tests), but they have a really short shelf life.

According to Dr. Koelker, two other signs that make strep more likely are a rash on the abdomen and tiny red spots on the roof of the mouth.

The Centor Criteria for diagnosing strep throat can help you determine whether your child's sore throat is strep and if it would even benefit from antibiotics.
 
Age
Under 3 years, strep is highly unlikely
0

3-14 years
+1

15-44 years
  0

45+
-1
Pus on tonsils
No       0
Yes +1
Tender, swollen neck glands
No       0
Yes +1
Fever above 100.4 F
No       0
Yes +1
Cough
No       +1
Yes   0



According to the CDC, physicians shouldn't even check for strep unless at least two criteria are met. Antibiotics shouldn't be prescribed unless at least three criteria are met, unless there is a positive strep test. However, even if the criteria are not satisfied for strep throat, it does not mean that the patient doesn't have a serious illness or bacterial infection. It just means that the patient does not have strep throat. If the sore throat persists more than three days, the patient should really be evaluated for other causes for the pain. If the patient's condition worsens, there could be other severe conditions that would warrant the use of antibiotics.

Regardless of whether your child has strep, there are measures you can take to alleviate the pain and that do not involve using your conventional antibiotic supply. All of the following herbal remedies have been proven in clinical trials to eliminate the Streptococcus bacteria.

  • Usnea tincture. Put a dropperful in a glass of water and gargle several times each day.
  • Thyme infusion. Put a teaspoon of thyme leaves in a cup of boiling water. Cover and let steep for 10-15 minutes. Add honey to sweeten. Use three to four times per day.
  • Listerine. Gargle with it.
  • Japanese honeysuckle blossoms. Put one tablespoon of dried flowers in a cup of boiling water. Cover and let steep for 10 minutes. Sweeten with honey. Use three to four times per day. This remedy will likely be the most happily taken by children.
  • Echinacea tincture. A full dropperful, held in the mouth and mixed with lots of saliva, swished around, and then swallowed as slowly as possible. Use four times per day.

If, however, you decide to go the traditional antibiotic route, here are the standard dosages physicians use for treating strep throat:

  •  Amoxicillin, 500 mg twice per day for 10 days; in children, 250 mg two to three times per day; or 25-50 mg/kg total per day.
  • Cephalexin, 500 mg twice per day for 7-14 days.
  • Erythromycin, 250 mg four times per day for 7-14 days.
  • Penicillin, 500 mg two to three times per day for 10 days.

Links to related posts:Usnea tincture
Thyme
Acquiring Antibiotics
Japanese honeysuckle
Echinacea
Armageddon Medicine 

For further reading:
https://www.mdcalc.com/centor-score-modified-mcisaac-strep-pharyngitis#next-steps
Dr. Cynthia Koelker, Armageddon Medicine, pp 143-145.

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