Sore Throat:

Sore throats are a common problem in pediatrics. Everyone has had them, and everyone knows how frustrating and uncomfortable they can be. Most sore throats are caused by a viral infection. These are commonly associated with colds, and do not respond to antibiotic treatment. A few, however, are caused by a bacterial infection called Streptococcus. This type of infection does respond to antibiotics, and should be treated.

For this reason, your physician may choose to do a throat culture on your child. If the test is positive, indicating Streptococcus, your physician will prescribe a course of antibiotic treatment. It is important that you finish all of the antibiotic.

If your child has Streptococcus, and antibiotics are prescribed, you can expect your child to be feeling better in about 48 hours. Many children will feel better in less time. It is important that your child not return to school or day-care until at least 24 hours after the start of antibiotic therapy. This is to reduce the risk of infecting the other children.

Why not treat all sore throats?

Some parents will wonder why we do not prescribe antibiotics for all sore throats, since some of them may be caused by Streptococcus. The reason is twofold.

If we were to prescribe antibiotics to every child with a sore throat, we would essentially be giving it to every child with a cold or allergies or any of a number of other conditions that are not treated with antibiotics. This would expose a great number of children to antibiotics with absolutely no benefit for them. While antibiotics are exceedingly safe, they still have a tiny risk. Thus, if we expose vast numbers of children to them, we take a small risk with those children, with no benefit for them. We cannot do this in good conscience.

Perhaps more important is the fact that using antibiotics in vast numbers of children will lead to an increasing number of resistant organisms. You may have read in the newspapers about problems in hospitals and other places with difficult infections that do not respond to any of our antibiotics. The careless use of antibiotics leads to this type of problem. If we were to give antibiotics to every child with a sore throat, we would be seeing even more resistant organisms.

Home Therapy:

Whether or not your child requires antibiotics, there are a number of things you can do at home to make your child more comfortable. Among them are:

• cool drinks,
• lozenges,
• gargling (with saltwater, for example),
• acetaminophen, and
• ibuprofen.

Call your physician's office immediately if:

• Your child has difficulty breathing.
• Your child is drooling.

Call your physician's office during normal office hours if:

• Your child has a sore throat accompanied by a fever.
• Your child's sore throat does not improve within a few days.
• You have any other questions or concerns.