Any Pediatricians here - antibiotics for strep if symptoms are gone?

[Anonymous]

Waiting on call back from Ped, but figured I'd try crowdsourcing this in the meantime.

5 year old came down with strep last week and is on day 5 of abx. 8 year old started feeling bad with sore throat Thur night, so went to Minute Clinic Fri morning - negative rapid strep test. She felt bad that day with ~99 degree fever, but has seemed perfectly fine the rest of the weekend. But just got a voice mail that the strep culture was positive. So do we treat with antibiotics now even though she seems to be getting better? I'll note that this is actually round 2 of strep for both kids this summer - they both had it (and were treated with amoxicillin for it) 3 weeks apart back in June.

[Anonymous]

Whatever you do, always complete the FULL COURSE of antibiotics or you risk bacterial resistance. The world is running out of alternatives for resistant bacteria.

[Anonymous]

Personally-if I can avoid starting a course of antibiotics, I would. Strep can resolve without it. The fewer antibiotic courses anyone has to take the better.

[Anonymous]

If they had it back in June--this might be a relapse. Do whatever the Ped recommends--this is not something you should crowdsource.

[Anonymous]

Anonymous wrote:Whatever you do, always complete the FULL COURSE of antibiotics or you risk bacterial resistance. The world is running out of alternatives for resistant bacteria.

+1

[Anonymous]

Finish the course you have started. Always. You feel better after the majority of the bacteria are dead BUT leaving a small percentage alive by not finishing the course is promoting resistance.

[Anonymous]

Anonymous wrote:Personally-if I can avoid starting a course of antibiotics, I would. Strep can resolve without it. The fewer antibiotic courses anyone has to take the better.

Please don't listen to this misinformed poster. I'm a retail pharmacist. Strep symptoms may go away but the bacteria will still live in the the body. She can still be contagious. Untreated step throat can lead to heart damage. Get her antibiotics and finish the full 10 day course ASAP.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Personally-if I can avoid starting a course of antibiotics, I would. Strep can resolve without it. The fewer antibiotic courses anyone has to take the better.

Please don't listen to this misinformed poster. I'm a retail pharmacist. Strep symptoms may go away but the bacteria will still live in the the body. She can still be contagious. Untreated step throat can lead to heart damage. Get her antibiotics and finish the full 10 day course ASAP.

I just reread your post. She is no longer contagious but needs to complete the full course. Not finishing places a risk of reinfection, and fully untreated step throat can lead to heart damage and complications.

[Anonymous]

OP here. To be clear this is for our 8 yo who has NOT yet started antibiotics. 5 yo who is already on day 5 will of course complete her round - it is just the question of whether to give abx for an illness that is (apparently) being successfully fought off.

Still waiting on call back from On-Call Ped, though don't know if I'll actually get one. But did speak to the Minute Clinic rep who explained the (small) risk of subsequent rheumatic fever as the reasoning for prescribing abx after symptoms have passed for strep when they wouldn't for other bacterial infections.

On the relapse front, that's a possibility, but strep is also going around my kid's school so I suspect they were just exposed again.

[Anonymous]

If 5 year old did not have strep you would never had 8 year old tested..she has probably had strep other times and it has gone away on its own.

[Anonymous]

I would treat. Strep can lead to all kinds of nasties - RHF, sydenham's chorea, PANDAS, and other complications. I'm pretty abx averse, but i would treat strep.

[Anonymous]

Anonymous wrote:If 5 year old did not have strep you would never had 8 year old tested..she has probably had strep other times and it has gone away on its own.

m


Strep does not go away. The symptoms disappear but it still lives in the body. Untreated strep can lead to heart damage. Please don't post on a subject you are ill-informed about.

[Anonymous]

Anonymous wrote:OP here. To be clear this is for our 8 yo who has NOT yet started antibiotics. 5 yo who is already on day 5 will of course complete her round - it is just the question of whether to give abx for an illness that is (apparently) being successfully fought off.

Still waiting on call back from On-Call Ped, though don't know if I'll actually get one. But did speak to the Minute Clinic rep who explained the (small) risk of subsequent rheumatic fever as the reasoning for prescribing abx after symptoms have passed for strep when they wouldn't for other bacterial infections.

On the relapse front, that's a possibility, but strep is also going around my kid's school so I suspect they were just exposed again.

OP, please treat. A rapid strep test only tests for 4 strains. Your child could still have strep, as evidenced above by the positive culture but negative rapid test. If your child has not been on an antibiotic for this round, she is will contagious. You have to be on an antibitioic for 24 hours before the contagious period ends. Even though she is feeling better, the virus is living inside of her. She will get it again. UNTREATED STREP CAN LEAD TO HEART DAMAGE. Pleas wt her on a round of antiobtiocs ASAP.

[Anonymous]

I'm not sure if strep can ever go away on its own or lingers. But I will tell you that it absolutely CAN become asymptomatic and remain in your body causing damage. BTDT. I'm not big on abx but I would do it in this situation.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Personally-if I can avoid starting a course of antibiotics, I would. Strep can resolve without it. The fewer antibiotic courses anyone has to take the better.

Please don't listen to this misinformed poster. I'm a retail pharmacist. Strep symptoms may go away but the bacteria will still live in the the body. She can still be contagious. Untreated step throat can lead to heart damage. Get her antibiotics and finish the full 10 day course ASAP.

+1 Definitely