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Antibiotics: Overused for Sore Throats?

Many Kids Are Getting Antibiotic Treatments When They Don't Have Strep Throat
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Kids and Strep Tests

The researchers found that a test that confirms strep throat was given only about half the time and seemed to have no impact on whether physicians prescribed antibiotics or not.

"All kids should be given a strep test before they are treated with antibiotics," Linder says.

But that doesn't mean that every child who sees the doctor for a sore throat needs a strep test, he adds. If other symptoms indicate a cold or other viral infection no test may be needed.

Linder notes that symptoms not suggestive of strep throat include:

  • Sniffles or runny nose
  • Cough
  • Hoarse voice
  • Pink eye
  • Diarrhea

Symptoms, other than sore throat, that suggest strep throat include:

  • High fever
  • Sudden onset of symptoms
  • Abdominal pain
  • Nausea and vomiting
  • Headache
  • Tender lymph nodes in the neck

"It isn't always clear with kids, though, and that is why testing is so important if there is any question," he says.

The Wrong Drugs

The world's first antibiotic remains the drug of choice for the treatment of children with strep throat. Leading pediatric and infectious disease groups, including the CDC, recommend penicillin whenever possible. Acceptable alternatives include three other long-relied on antibiotics -- amoxicillin, erythromycin, and first-generation cephalosporins.

But newer, nonrecommended antibiotics were prescribed to 27% of the patients who received an antibiotic. Linder speculates that the physicians and/or parents mistakenly believed that "newer" meant better.

"The irony is that the bug that causes strep throat is sometimes resistant to these newer antibiotics, but it is never resistant to penicillin," he says. "Penicillin is well tolerated, inexpensive, and it has a narrow spectrum of activity, meaning that it targets the bug that causes strep throat and little else."

The bottom line, Linder says, is that most kids with sore throats probably shouldn't be taking antibiotics, and a strep test should always be given before antibiotics are prescribed.

J. Todd Weber, MD, who directs the Office of Antimicrobial Resistance at the CDC, agrees.

Weber tells WebMD that he believes doctors and the lay public have gotten the message about the dangers of antibiotic overuse for society. But that may not be translating to the care of the individual patient.

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