Strep--treat with antibiotics or not?

[Harriet Vane]

My dd has strep. The rapid test was negative, but the 2-day culture is positive for strep. She has had a fever since Sunday. Sun-Mon-Tues-Wed her fever hovered up in the 103 range except when I gave her meds to help her sleep. Today it's been at 102ish.

 

The ped is enthusiastic about antibiotics (amoxicillin). I am not opposed to meds but am cautious in my use of them.

 

On the one hand, I have read that antibiotics only shorten the duration of strep by one day.

 

On the other hand, the ped was elaborate and specific in her description of potential heart damage if rheumatic fever develops.

 

She was also honest, though, about the fact that less than 1% of people with strep will go on to develop heart complications. (She looked it up for me.)

 

Opinions?

 

ETA--I really appreciate your opinions so far. Can you please elaborate a little and help me understand? Rather than a simple yes/no, throw some information on the table for me to chew over.

 

FWIW, I tend to be cautious about meds because I personally tend to react badly to meds. If there is a nasty side effect, I WILL experience it. When a dr says antibiotics, to me that is a guaranteed yeast infection. Dd has a different body and responds differently, but I cannot quite shake my caution and need to have some facts to help me walk forward. Thanks!

Edited April 5, 2012 by strider

[abbeyej]

Absolutely, 100% YES with confirmed strep. Yes, sometimes people recover without problems. But there are various complications of untreated strep that can cause life-long consequences.

[wapiti]

:iagree: Absolutely, without question. Do not let strep go untreated.

 

I just noticed there's a PANDAS thread on the SN board, also.

[itsheresomewhere]

For strep- YES. We use antibiotics only when we have too. Even our very cautious ped would prescribe for strep.

 

 

The rapid strep test should be thrown out in the garbage as it has a history of not being correct. Our ped won't use it.

[Mommyfaithe]

Absolutely, 100% YES with confirmed strep. Yes, sometimes people recover without problems. But there are various complications of untreated strep that can cause life-long consequences.

 

:iagree: 100%

[higginszoo]

My father-in-law lost both of his kidneys to untreated strep. Any risks that would have come with the antibiotics probably wouldn't have come close to the fallout that came from not treating. Thankfully, the transplant from his sister was more successful than they even hoped, and he'll have had it for 30 years this fall.

[J-rap]

Yes, yes, yes! Do not let strep go untreated! Strep is not something to mess with.

[Whereneverever]

Um, yes. We always treat confirmed strep with antibiotics.

[Harriet Vane]

Absolutely, 100% YES with confirmed strep. Yes, sometimes people recover without problems. But there are various complications of untreated strep that can cause life-long consequences.

 

I well remember your hard road through PANDAS with your son.

 

Does PANDAS affect older children or adults as well?

[Random]

I will be the lone dissenter and admit that I treat Strep in myself by gargling with cayenne pepper in water. When my 1 year-old baby had Strep, though, I gave her antibiotics.

[Lovin Learnin]

I will go with most everyone else and say treat it since untreated strep can potentially develop into much more serious issues.

[swellmomma]

I generally believe in letting illneses run their course without medicating. Strep is one that I hit full force as early as possible with antibioitcs. IN fact If I suspect strep I have my child start the antibiotics before the culture is back I would rather treat for 2 days erroneously than wait those 2 days to start. Strep has far too many complications to leave it be. Unlike other illnesses that hit their target area and then pretty much stay there (like an ear infection) they make the person miserable but over all it is fine to run it's course. But strep is a sneaky bugger that doesn't like to stay put. The risks to secondary infections, heart involvement etc make it one that I will never mess around with.

[Catherine]

Rheumatic fever, which can destroy the heart valves, is a complication of untreated strep, as are kidney failure and a form of arthritis.

[Miss Peregrine]

One of my DDs had PANDAS after strep. I will always treat it if it is diagnosed. Another DD is at urgent care right now with possible strep.

[twoxcell]

Yes, I would not mess around with strep at all. My ds has had scarlet fever twice.:001_huh:

[melissad2]

Absolutely, 100% YES with confirmed strep. Yes, sometimes people recover without problems. But there are various complications of untreated strep that can cause life-long consequences.

 

:iagree:

I'm a nurse and I agree. My kids have only taken antibiotics a very few times because I am weary of overuse as is my pediatrician but in the case of confirmed strep I would absolutely treat it.

[Blueridge]

My youngers have had an antibiotic only once in their lives, and that was when they both had strep.

[goldberry]

The reason to treat is that the possible consequences of non-treatment outweigh any possible adverse side effects of treatment. Untreated strep can cause a host of SERIOUS issues. Granted, it often doesn't, but since it CAN, and the outcome CAN be severe, I would never take any chances with strep.

 

IE, untreated ear infection mostly heals on its own. If it doesn't, you can still go get antibiotics later and be fine. Strep, if you don't treat it right away, sometimes you have missed the window and can have severe consequences. So, not worth the risk.

[sassenach]

Always with strep. No hesitation.

[Harriet Vane]

Okay, heading to the pharmacy now. Thanks for the input.

[TGHEALTHYMOM]

I use OLIVE LEAF EXTRACT for a POWER PACKED antibiotic, antiviral, anti yeast cure for most of our illnesses.

[TranquilMind]

My dd has strep. The rapid test was negative, but the 2-day culture is positive for strep. She has had a fever since Sunday. Sun-Mon-Tues-Wed her fever hovered up in the 103 range except when I gave her meds to help her sleep. Today it's been at 102ish.

 

The ped is enthusiastic about antibiotics (amoxicillin). I am not opposed to meds but am cautious in my use of them.

 

On the one hand, I have read that antibiotics only shorten the duration of strep by one day.

 

On the other hand, the ped was elaborate and specific in her description of potential heart damage if rheumatic fever develops.

 

She was also honest, though, about the fact that less than 1% of people with strep will go on to develop heart complications. (She looked it up for me.)

 

Opinions?

 

ETA--I really appreciate your opinions so far. Can you please elaborate a little and help me understand? Rather than a simple yes/no, throw some information on the table for me to chew over.

 

FWIW, I tend to be cautious about meds because I personally tend to react badly to meds. If there is a nasty side effect, I WILL experience it. When a dr says antibiotics, to me that is a guaranteed yeast infection. Dd has a different body and responds differently, but I cannot quite shake my caution and need to have some facts to help me walk forward. Thanks!

You always have to treat strep. I am as nonmainstream as they go, but I treat strep.

[redsquirrel]

I know too many older adults who suffer from the repercussions of untreated strep to take a chance. Rheumatic fever is not fun. My family ped is very conservative with abx. Only one of my kids has ever had abx and it was for strep.

 

A lifetime of heart problems are nothing to gamble with.

[magnificent_baby]

I know too many older adults who suffer from the repercussions of untreated strep to take a chance. Rheumatic fever is not fun. My family ped is very conservative with abx. Only one of my kids has ever had abx and it was for strep.

 

A lifetime of heart problems are nothing to gamble with.

 

:iagree:

 

My Grandma had rheumatic heart fever from strep when she was 10. She lived to be 79, but dealt with heart failure her entire life after the illness, including 3 open heart surgeries for valve replacements.

 

I always treat my kids for strep.

[gardenmom5]

maybe only 1% of people end up with rheumatic fever because they take antibiotics before it gets that bad.

 

absolutely do the antibiotics, and retest to make sure it is gone.

[OrganicAnn]

I am not up on the stats or anything, but I did know a girl in college who died from untreated strep. Very sad.

[Pammy]

has heart damage from a possible untreated strep infection when she was a toddler. We say possible because she could have been born with it, but it wasn't detected until she was three. She was a few weeks early, and had a few other issues as well.

[CalicoKat]

Absolutely, 100% YES with confirmed strep. Yes, sometimes people recover without problems. But there are various complications of untreated strep that can cause life-long consequences.

 

:iagree:

Even with treatment those life ling consequences can happen. I wish wish dearly that I didn't have one of them.

[rutamattatt]

Both of my boys have gotten scarlet fever from strep. Although they haven't shown any long term effects, we never mess with strep. I have a healthy (no pun intended) respect for what it can turn into if it spreads. :(

[kalanamak]

[/b]

My Grandma had rheumatic heart fever from strep when she was 10. She lived to be 79, but dealt with heart failure her entire life after the illness, including 3 open heart surgeries for valve replacements.

 

 

And it isn't just people of that generation. I've seen enough in much younger people from 3rd world countries. Valve replacement is no fun.

[AdventureMoms]

I very rarely use antibiotics. My kids have never had them, and I haven't had any in years (like a decade). However, for confirmed strep I would use antibiotics without hesitation. I'd be using probiotics too, though, to help the body recover from the antibiotics.

[PrincessAriel]

I say yes. I know of two adults, separate families, both were parents with young children, who died from strep complications within the past few years.

[TCB]

I would be interested to hear what other countries do about strep - from my experience North Americans treat it much more than some other countries. In England, for instance, they very rarely seemed to do throat cultures at all.

[Perry]

Well, I will have to dissent and say I don't think the answer is that clear at all. There is a very interesting article here, which suggests that antibiotics for strep may actually do more harm than good. The issue is that you have to weigh the risks and benefits, including the risks of treating. When you have a very rare adverse outcome (and in this country new cases of rheumatic heart disease are rare) it becomes more likely that the risks of the medication are higher than the risk of the illness.

 

<snip>

At Warren Air Force base only 50-60 recruits were treated to prevent one case. Today, preventing one case would likely require antibiotic treatment for hundreds of thousands of strep throats, making it a mathematical certainty that antibiotics will do more harm than good. For each case of rheumatic fever prevented in modern practice, a few dozen patients either die or suffer near-fatal anaphylaxis, toxic epidermal necrolysis, colitis, or other antibiotic reactions, and many thousands more suffer diarrhea, rashes, and yeast infections.

 

Fortunately, rheumatic fever has been declining for a century, starting well before the introduction of antibiotics. While strep throat is no less common today, ‘rheumatogenic’ strains have dwindled, leading epidemiologists to conclude that antibiotics have little or nothing to do with rheumatic fever’s disappearance. Changes in hygiene, nutrition, population crowding, access to care, and changes in the bacterium are all felt to be important factors, which explains why the disease is now typically seen most in third world settings.

 

There are, arguably, other reasons to consider antibiotics for pharyngitis, but the evidence does not rise to support them. The Cochrane group estimates a 16-hour reduction in symptoms with antibiotics, but ibuprofen, acetaminophen, or a single dose of corticosteroids is as good or better, with fewer side effects. And while peritonsillar abscess may be minimally reduced by antibiotics, abscesses typically present primarily rather than after strep throat, and in most cases are easily treated. No studies have shown that antibiotics reduce the transmission of strep or reduce other complications.

 

The administration of antibiotics for strep throat, endorsed universally by practice guidelines and professional societies, is based exclusively on data from the world’s most concentrated epidemic of rheumatic fever. Using this to guide modern therapy is like administering antibiotics to prevent bubonic plague.

 

The comments are interesting too. And there is a follow up here Antibiotics for Strep: Addressing Readers’ Concerns, if you're interested in this sort of thing. :)

 

BTW, we always treat our kids when they have strep. However, we don't test every single sore throat they get.

[DianeW88]

Yes, treat it with antibiotics. They are given to prevent rheumatic fever, not to make the strep throat go away...that will happen on its own.

[jubilation]

I'm typically cautious with antibx, but for strep, I would definitely give them. In addition to the risk of heart damage, there is also a small but very real risk of kidney damage.

 

I worked as a pediatrics floor RN a few years back, and I will never forget the athletic, healthy child I took care of, who came in with acute kidney failure. Investigation showed that she had had untreated strep several weeks before, and was now suffering from post-streptococcal glomerulonephritis as a complication. We had to transfer her to a larger hospital, and I'm pretty sure she ended up on dialysis temporarily while her body healed. :(

 

Very rare complication, but one that makes me very cautious when it comes to strep and my kids.

 

http://www.nlm.nih.gov/medlineplus/ency/article/000503.htm

Edited April 6, 2012 by jubilation
added link

[golfcartmama]

P

:iagree: Absolutely, without question. Do not let strep go untreated.

 

I just noticed there's a PANDAS thread on the SN board, also.

:iagree::iagree:

 

Just as a side note...I don't think Amoxicillian works great for strep, so make sure they retest her. We've had two instances where it didn't kill it and we had to do another stronger round, so my kids now take other abx when they get strep. PANDAS and other severe complications are very real.

[Jennifer in MI]

Our wonderful doctor who was as anti-antibiotic-unless-absolutely-necessary told me that antibiotics are the most helpful with strep after 3 - 4 days. I don't know if it was because it allowed the child's body to fight the infection on its own for a little while or what, but that's what he swore by. But, absolutely, he treated it!

 

My oldest has been on antibiotics twice (he'll be 16 next month). Once was for strep.

[Harriet Vane]

Well, I will have to dissent and say I don't think the answer is that clear at all. There is a very interesting article here, which suggests that antibiotics for strep may actually do more harm than good. The issue is that you have to weigh the risks and benefits, including the risks of treating. When you have a very rare adverse outcome (and in this country new cases of rheumatic heart disease are rare) it becomes more likely that the risks of the medication are higher than the risk of the illness.

 

<snip>

 

 

The comments are interesting too. And there is a follow up here Antibiotics for Strep: Addressing Readers’ Concerns, if you're interested in this sort of thing. :)

 

BTW, we always treat our kids when they have strep. However, we don't test every single sore throat they get.

 

Thank you Perry. I have always appreciated your well-reasoned approach.

 

I ended up agreeing to the antibiotics partially because I was spooked by the severity of possible negative outcomes, and also partially because dd has been so very, very healthy. I don't think she's had antibiotics since she was a toddler, so she is not at risk for overuse concerns right now. She is also eating yoghurt every day while on the amoxicillin.

 

In the meantime, thanks for the link and for the good information. I really appreciate having facts to ponder.

[Butter]

My sister has a heart problem due to untreated strep. We always use antibiotics for strep infections.