Child Health Guide: Holistic Pediatrics for Parents
Antibiotics for Strep Throat?
excerpt from Child Health Guide
(Adapted from Child Health Guide: Holistic Pediatrics for Parents, North Atlantic Books, 2005)
Most physicians will insist on treating strep throat with antibiotics. The specific organism is Group A beta-hemolytic streptococcus. The effectiveness of antibiotics for recovery from strep throat has been controversial, with early studies showing no effect on symptoms (Brink et al., 1951; Denny et al., 1953) and later studies showing dramatic improvement (Randolph et al., 1985). The second reason doctors treat strep with antibiotics is because they can prevent one of the complications of strep throat, acute rheumatic fever (ARF), which commonly damages heart valves and can prove fatal. Antibiotics do not seem to prevent some other complications, specifically toxic shock syndrome or kidney infections (Weinstein and Le Frock, 1971). However, the incidence of rheumatic fever has decreased dramatically since the time when thousands of people died every year from that extremely infectious and painful disease. In the late 1940s, 200,000 people per year developed rheumatic fever. The numbers began declining prior to the availability of antibiotics and ARF has nearly disappeared since the 1970s. Pockets of ARF occur sporadically in various small areas of the country, but rheumatic fever is now largely a disease of the past. Apparently, the strains of the bacteria that have an affinity for attacking the heart simply do not occur anymore except in rare, isolated instances (Markowitz, 1998; Stollerman, 1990). Once upon a time antibiotics prevented ARF that followed strep throat, but now the disease has virtually disappeared, despite the fact that most sore throats do not get treated. In fact, most cases of ARF now have no history of a preceding sore throat.
None of this would be an issue if antibiotics had no side effects. The problem is that they do. Antibiotics disrupt the immune system, and kill beneficial bacteria along with the pathogens. Antibiotics also tend to create resistant strains of bacteria so that they do not work effectively when they are really needed. A further complicating issue is that strep bacteria typically do not disappear from the throat following a course of antibiotics. The bacteria will persist even after signs of the infection have disappeared. If a throat culture is taken at some later date, the bacteria will still be present and another antibiotic prescription will follow even though there is no active infection. Finally, studies have shown that when antibiotics are given for strep throat, the infection tends to recur more often than when they are not prescribed.
I do not recommend getting a throat culture for sore throats, and I do not recommend antibiotics for strep throat unless an unusual number of ARF cases caused by strep bacteria have been documented in the community, or if you have pre-existing heart disease.
I agree with pediatrician Robert Mendelsohn, whose advice two decades ago remains true today:
“Both throat cultures and antibiotics are to be avoided, because the hazards of treatment outweigh the remote possibility that your child will suffer any lasting effects even if he has a strep infection” (Mendelsohn, 1984).
Homeopathic treatment is usually extremely effective in relieving the symptoms of sore throats and stimulating a complete and quick recovery. Strep throat may take longer to resolve than viral sore throats.
Belladonna is the first medicine to prescribe when the throat is inflamed, red, and painful with few other symptoms besides fever.
Mercurius (vivus or solubilis) is by far the most frequently indicated medicine for sore throats. Characteristic symptoms include a bad odor from the mouth, an increase in saliva production with drooling in younger children, swollen lymph nodes, and irritability.
The third medicine is Phytolacca when the throat feels swollen or constricted on swallowing and the lymph nodes are swollen, but the typical Mercurius symptoms of salivation and bad odor are absent.
Give vitamin C, Elderberry, and Echinacea as you would for colds.
A Chinese herbal formula such as Yin Chiao, or another specific formula for sore throats Herbal ENT (Evergreen) or CQ or CQ Jr (Blue Poppy), is also appropriate.
Symptomatic treatment includes eating frozen things (juice popsicles or ice chips), sucking on zinc lozenges, and, for older children and adults gargling with salt water.
Do not routinely get a culture for sore throats. Avoid antibiotics as the first line of treatment. Treat sore throats and the accompanying cold or flu symptoms with the appropriate homeopathic medicine, vitamin C, and herbal formulas with antiviral and antibacterial properties.