What a Health Care Practitioner Should Tell a Parent or Child’s Caregiver About Strep Throat

Strep throat is a common infection in children that can cause a sore throat and other symptoms. It is caused by a type of bacteria called group A streptococcus (strep A), which can also cause other infections such as scarlet fever, impetigo, and cellulitis. Most cases of strep throat are mild and can be easily treated with antibiotics, but some children may develop serious complications such as rheumatic fever or invasive group A streptococcal infection (iGAS), which can be life-threatening. This article will provide some information on what a health care provider should tell a parent or child’s caregiver about strep throat.

How to recognise strep throat in children

Strep throat can be recognised by the following symptoms:

• A sore throat that may be red, swollen, or have white patches.
• Fever (a high temperature above 38C)
• Swollen glands in the neck
• Headache
• Nausea and vomiting
• Sometimes a rash that feels rough like sandpaper (scarlet fever)

The symptoms usually start within 2 to 5 days of exposure to the bacteria and last for about a week. Strep throat is more common in children aged 5 to 15 years but can also occur in adults or younger children.

How to diagnose strep throat in children

Strep throat can be diagnosed by a doctor, or an advanced practice health care provider based on the symptoms and signs of the infection. The practitioner may also take a swab from the back of the child’s throat and send it to a laboratory for testing. This can confirm if the child has strep A or another cause of sore throat. The test results may take a few days to come back.

How to treat strep throat in children

Strep throat can be treated with antibiotics, usually penicillin or amoxicillin. The child should start feeling better within 24 hours of taking the antibiotics, but they should complete the full course as prescribed by the practitioner. This will help prevent the infection from coming back or causing complications.

The child should also stay at home and rest until they are feeling well and have no fever. They should drink plenty of fluids and eat cool or soft foods. They should avoid smoking or smoky places and take paracetamol or ibuprofen to reduce pain and fever.

The child should also avoid contact with other people until they have been on antibiotics for 24 hours. This will help prevent the infection from spreading to others.

How to prevent strep throat in children

Strep throat can be prevented by practising good hygiene and avoiding close contact with people who have the infection. Some tips include:

• Washing hands frequently with soap and water or using alcohol-based hand sanitiser
• Covering the mouth and nose with a tissue or elbow when coughing or sneezing
• Disposing of used tissues in a bin
• Not sharing cups, cutlery, toothbrushes, or other personal items
• Cleaning surfaces and objects that may be contaminated with germs
• Keeping up to date with immunisations, especially for children who have had rheumatic fever or are at risk of iGAS

When to seek medical help for strep throat in children

Most cases of strep throat are not serious and can be treated at home with antibiotics and supportive care. However, some children may develop complications or signs of a more severe infection that need urgent medical attention. Parents or caregivers should call NHS 111 or contact their health care provider if their child:

• Has a high temperature that does not come down with paracetamol or ibuprofen.
• Has difficulty breathing, swallowing, or opening their mouth.
• Has severe pain in their throat, chest, abdomen, or joints.
• Has a rash that feels rough like sandpaper (scarlet fever)
• Has signs of dehydration such as dry mouth, sunken eyes, reduced urine output, or drowsiness.
• Has any other symptoms that worry them or do not improve after taking antibiotics.

Parents or caregivers should call 999 or go to A&E if their child:

• Has difficulty breathing - they may make grunting noises, or their tummy may suck under their ribs
• Has pauses when they breathe.
• Has blue or grey skin, tongue, or lips - on black or brown skin this may be easier to see on the palms of the hands or soles of the feet.
• Is floppy and will not wake up or stay awake.

These could be signs of iGAS, which is a rare but life-threatening condition that needs immediate treatment in hospital.

Conclusion

Strep throat is a common infection in children that can cause a sore throat and other symptoms. It is usually mild and can be easily treated with antibiotics at home. However, some children may develop serious complications that need urgent medical help. Parents or caregivers should be aware of the signs and symptoms of strep throat and seek advice from a doctor or advanced health care practitioner if they are concerned about their child’s health.

Practitioner Development UK (PDUK) is a leading provider of continuing professional development (CPD) courses for healthcare professionals. We offer a wide range of courses, delivered both as scheduled events and in-house.

If you are a health care provider and want to learn more about common paediatric minor illnesses in primary care, we recommend our:

 RCN accredited Paediatric Minor Illness Essentials course:

This course concentrates on childhood minor illnesses from infancy to late teen years. Ideal for the practitioner who is confident with history taking and physical examination skills and wants to explore a variety of paediatric conditions in an evidence-based context.