Stephen J. Schueler, M.D.

Strep Pharyngitis Home Care

Home care for bacterial pharyngitis includes:

Strep Pharyngitis Fever in Adults

Medications commonly used to control pain and fever in adults with bacterial pharyngitis include:


Acetaminophen
  • Acetaminophen decreases fever and pain, but does not help inflammation.
  • Adult dosing is 2 regular strength (325 mg) every 4 hours or 2 extra-strength (500 mg) every 6 hours.
  • Maximum dose is 4,000 mg per day.
  • Avoid this drug if you have alcoholism, liver disease or an allergy to the drug. See the package instructions.
  • Common brand names include Tylenol, Panadol, and many others.

Aspirin

Ibuprofen

Naproxen

Ketoprofen

NSAID Precautions

Strep Pharyngitis Fever in Children

Common medications used at home for fever in children with bacterial pharyngitis include:


Aspirin and most of the other nonsteroidal anti-inflammatory drugs (NSAIDS) are not used in children except under a doctor's care.

Acetaminophen
  • Acetaminophen decreases fever and pain, but does not help inflammation.
  • Dosing is 10-15 mg per kilogram (5-7 mg per pound) of body weight every 4-6 hours, up to the adult dose.
  • Do not exceed the maximum daily dose.
  • Acetaminophen products come in various strengths. Always follow the package instructions.
  • Avoid this drug in children with liver disease or an allergy to acetaminophen.
  • Common acetaminophen products include Tylenol, Panadol and many others.

Ibuprofen

Naproxen

Strep Pharyngitis Sore Throat Adults

Home care for a sore throat in an adult with bacterial pharyngitis includes:

  • Avoid alcohol.
  • Avoid citrus juice.
  • Avoid hot and spicy foods.
  • Stop smoking.
  • Avoid exposure to secondary smoke.
  • Drink plenty of fluids.
  • Get plenty of rest.
  • Numb the throat pain with throat spray or lozenges.
  • Perform warm salt water gargles several times a day. Mix 1/2 teaspoon (92.5 ml) salt per cup (240 cc) of water.
  • Place a vaporizer or nebulizer in the bedroom at night.
  • Nonsteroidal anti-inflammatory medications for pain.
  • Acetaminophen for pain.

Strep Pharyngitis Sore Throat Children

Home care for a sore throat in a child with bacterial pharyngitis includes:

  • Avoid citrus juice.
  • Avoid hot and spicy foods.
  • Avoid exposure to secondary smoke
  • Drink plenty of fluids.
  • Get plenty of rest.
  • Numb the throat pain with throat spray or lozenges.
  • Perform warm salt water gargles several times a day. Mix 1/2 teaspoon (92.5 ml) salt per cup (240 cc) of water.
  • Place a vaporizer or nebulizer in the bedroom at night.
  • Nonsteroidal anti-inflammatory medications for pain.
  • Acetaminophen for pain.

Strep Pharyngitis Vomiting in Adults

Home care for vomiting in an adult with bacterial pharyngitis:

  • Drink clear liquids only, such as water, sports drinks, fruit juice and dilute tea. Sports drinks are best. The absence of food allows the intestines to rest.
  • Drink small quantities of fluids frequently. In general, two tablespoons of fluid every 5 minutes is an effective strategy.
  • Avoid milk and dairy products for 3 days.
  • Avoid liquids that irritate the stomach, such as citrus juice, alcohol and coffee.
  • If nausea or vomiting continues despite the above, consider one of the nonprescription medicines listed below.
  • Once vomiting and nausea resolves, start bland foods first. If you tolerate bland food, then you can resume a normal diet.

Nonprescription medications for vomiting include:

Strep Pharyngitis Vomiting in Children

Home treatment of vomiting in children with bacterial pharyngitis includes hydration and dietary therapy. Those who are able to drink liquids can restore lost water and salt with oral rehydration therapy (ORT).

ORT fluids used in infants include:

  • Infalyte
  • Lytren
  • Naturalyte
  • Pedialyte
  • Rehydralyte

ORT fluids used in older children include:
  • Sports drinks (Gatorade)
  • Broth
  • Dilute fruit juices
  • Flat soda
  • Weak tea with sugar

Strategies for breast-fed infants younger than 6 months:
  • If the infant tolerates breast milk, continue breast-feeding in small amounts very frequently.
  • Provide additional ORT fluids to supplement breast milk.
  • Feed very small amounts every 30-60 minutes, or try giving small amounts more frequently, such as:
    • Children up to 5 kg (11 lb): give 5 ml (1 teaspoon) every 5 minutes
    • Children 5-10 kg (11-22 lb): give 10 ml (2 teaspoons) every 5 minutes
  • Watch for dehydration: dry mouth, decreased urination, dark yellow urine and lack of tears.

Strategies for formula-fed infants younger than 6 months:
  • If the infant tolerates formula, continue to provide small amounts very frequently.
  • Provide additional ORT fluids to supplement formula.
  • Try giving small amounts more frequently, such as:
    • Children up to 5 kg (11 lb): give 5 ml (1 teaspoon) every 5 minutes
    • Children 5-10 kg (11-22 lb): give 10 ml (2 teaspoons) every 5 minutes
  • Watch for dehydration: dry mouth, decreased urination, dark yellow urine and lack of tears.

Strategies for children over 6 months:
  • Provide as much ORT fluids as your child desires.
  • If vomiting occurs, provide small amounts of ORT fluids more frequently:
    • Children 10-20 kg (22-44 lb): 15 ml (1 tablespoon) every 5 minutes
    • Children 20-40 kg (44-88 lb): 22 ml (1 and 1/2 tablespoons) every 5 minutes
    • Children 40 kg (88 lb) and over: 30 ml (2 tablespoons) every 5 minutes
  • Watch for dehydration: dry mouth, decreased urination, dark yellow urine and lack of tears.

Dietary Therapy
Most children with vomiting improve in a few hours and symptoms usually resolve in one day. Once vomiting and nausea resolves, provide bland foods first. If bland foods are tolerated, then you resume a normal diet.

Foods that are easiest to tolerate include:
  • Crackers
  • Oatmeal
  • Jell-O
  • Soft foods
  • Yogurt

Foods to avoid include:
  • Concentrated fruit juices
  • Junk foods
  • Milk products
  • Recently introduced foods
  • Spicy foods

Nonprescription medicines for vomiting should only be used under the direction of your doctor.

Strep Pharyngitis Warning Signs

Notify your doctor if you have bacterial pharyngitis and any of the following:

Continue to Strep Pharyngitis Prevention

Last Updated: Dec 1, 2010 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
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PubMed Strep Pharyngitis References
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  2. Cohen R. Defining the optimum treatment regimen for azithromycin in acute tonsillopharyngitis. Pediatr Infect Dis J. 2004 Feb;23(2 Suppl):S129-34. [14770076]
  3. Cooper RJ, Hoffman JR, Bartlett JG, Besser RE, Gonzales R, Hickner JM, Sande MA; American Academy of Family Physicians; American College of Physicians-American Society of Internal Medicine; Centers for Disease Control. Principles of appropriate antibiotic use for acute pharyngitis in adults: background. Ann Intern Med. 2001 Mar 20;134(6):509-17. [11255530]
  4. Huovinen P. Causes, diagnosis and treatment of pharyngitis. Compr Ther. 1999 Jun-Jul;25(6-7):326-9. [10470516]
  5. Linder JA, Stafford RS. Antibiotic treatment of adults with sore throat by community primary care physicians: a national survey, 1989-1999. JAMA. 2001 Sep 12;286(10):1181-6. [11559262]
  6. Tewfik TL, Al Garni M. Tonsillopharyngitis: clinical highlights. J Otolaryngol. 2005 Jun;34 Suppl 1:S45-9. [16089240]
  7. Zwart S, Sachs AP, Ruijs GJ, Gubbels JW, Hoes AW, de Melker RA. Penicillin for acute sore throat: randomised double blind trial of seven days versus three days treatment or placebo in adults. BMJ. 2000 Jan 15;320(7228):150-4. [10634735]
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