Recurrent Strep Throat: What to Do When Strep Comes Back

Strep throat is caused by infection with the Streptococcus pyogenes bacterium, also known as group A streptococcus.

These bacteria are highly contagious. They can spread through aerosolized droplets when someone with the infection coughs or sneezes or through shared food. You can also pick them up from a surface or doorknob and transfer them to your nose, mouth, or eyes.

Most people find quick relief with antibiotics. But what do you do if the strep throat keeps coming back?

At Mercy Medical Urgent Care, Dr. Bilal Khoder and our staff regularly diagnose and treat strep throat, mostly during the winter months when everyone’s inside, and it’s hard to avoid contact. 

Here’s what our team wants you to know about recurrent strep throat and what we can do to help.

Strep throat symptoms and complications

Signs and symptoms of strep throat can include:

• Throat pain that usually comes on quickly
• Painful swallowing
• Red, swollen tonsils; may have white streaks of pus
• Tiny red spots at the back of the roof of the mouth
• Swollen, tender lymph nodes in your neck
• Fever
• Headache
• Rash
• Nausea or vomiting, especially in younger children
• Body aches

Call Mercy Medical Urgent care if you or your child has any of the following:

• A sore throat together with tender, swollen lymph glands
• A sore throat lasting longer than 48 hours
• A sore throat along with a rash
• A fever
• Difficulty breathing or swallowing

Let us know if we diagnose strep and the antibiotics we prescribe don’t lead to an improvement in your condition after 48 hours.

Left untreated, a strep infection can lead to serious inflammatory illnesses, like scarlet fever and rheumatic fever (affects heart, joints, nervous system, and skin).

Why does strep recur?

First, when you start taking antibiotics, you may begin to feel better within 12-24 hours. However, that doesn't mean the infection is gone, so it’s important to finish the full course of antibiotics.

Stopping the medication early not only means the bacteria can hang around and start another infection, but they may also build up a tolerance to the antibiotic, making them less likely to respond in the future.

Second, the gold standard for treating strep is amoxicillin, a cousin to penicillin. Unfortunately, not everyone can take it because allergies to penicillin are common. That means our doctor may need to prescribe another antibiotic that’s less effective due to resistance.

As a result, you may need to take a second course of the drug or another antibiotic altogether to fully eliminate the infection.

Third, some people have strep bacteria living on their tonsils all the time. They’re called carriers because they have the bacteria without the symptoms.

If they get a strep test, the results are going to be positive. The person may not know they’re carriers.

Doctors believe that as many as 25% of children are carriers of strep throat.

The way to determine if you or your child is a carrier is to come in for a test a few weeks later, when you’re not having symptoms. If the test comes back positive, you’re likely a carrier.

Fourth, you may become reinfected even after you take antibiotics. 

In places like schools, reinfection is often unavoidable.

It’s the same with families. By the time it’s made the rounds, the first kid who was infected is able to become reinfected. Practicing good hygiene can help.

You can even reinfect yourself. Strep bacteria can survive on surfaces for several days, and you can pick them up by touching them. This is common with toothbrushes. Change to a new toothbrush after the second day of being on the antibiotic to prevent reinfection.

If you or your child is dealing with a sore throat, especially if they’ve had strep and this is a recurrent infection, it’s time to come into Mercy Medical Urgent Care for an evaluation and tailored treatment. We’re open seven days a week. Walk in or give us a call at 386-758-2944 to schedule an appointment.