Sore Throat

Bacterial throat infections, also known as bacterial pharyngitis or strep throat, are caused by bacteria like Streptococcus pyogenes. While sore throats are commonly caused by viruses and resolve without treatment, bacterial infections can lead to complications if left undiagnosed and untreated.

Bacterial throat infections differ from viral ones in important ways. Viral sore throats, like those accompanying colds, often cause runny noses, coughs, and congestion, whereas bacterial sore throats more commonly lead to fever, swollen lymph nodes, white patches on the tonsils, and throat pain without other upper respiratory symptoms.

Cases of bacterial throat infections surged last year, likely connected to schools reopening after pandemic closures.

Experiencing a bacterial throat infection can be quite uncomfortable. The most common symptoms include:

• Sore throat - Often severe pain that makes it difficult to swallow or speak
• Fever - Usually between 38°C - 40°C
• Swollen lymph nodes in the neck
• White or yellow patches on the tonsils
• Headache
• Rash (in some cases like scarlet fever)
• Nausea, vomiting, stomach pain

At The Independent Pharmacy, we can treat patients who are 18+ and have the following symptoms:

• Fever in the last 24 hours
• Swollen pus covered tonsils
• Attending rapidly (within 3 days after onset of symptoms)
• Severely inflamed tonsils
• No cough or runny nose

While most sore throats are caused by viruses and improve within days, a bacterial throat infection brings more severe pain without other upper respiratory symptoms like a runny nose or cough. The pain often comes on very quickly.

Please note that you should call 999 if you experience any of the following concerning symptoms:

• Your symptoms are severe and getting worse quickly
• You're making a high-pitched sound while breathing
• You drool
• You can't swallow or have difficulty breathing

Getting the right diagnosis is crucial for effective treatment. This typically involves a physical exam and a throat swab to confirm the presence of strep bacteria, as it's often challenging to determine the cause based solely on symptoms. However, severe pain, fever, and lack of cough/congestion may indicate a bacterial origin.

While some of the symptoms may point to a bacterial cause, an accurate diagnosis of bacterial throat infection requires medical testing. The most common diagnostic methods include:

• Physical exam - The healthcare provider will examine the throat for signs of infection, such as swollen tonsils with white patches and pus. They will also check for swollen lymph nodes in the neck, fever, and rashes.
• Throat swab test - The doctor uses a cotton swab to take a sample from the throat, which is then sent to a lab to check for the presence of strep bacteria.
• Rapid antigen testing - Some doctor's offices and clinics can provide rapid tests for strep bacteria, with results available in minutes. This involves using the throat swab sample to look for antigens found in strep bacteria.
• Blood tests - Blood tests - In some cases, a blood test might be used to check for signs of a recent strep infection, although this is less common.

Proper diagnosis is important, as most sore throats are caused by viruses and will resolve without antibiotics. Accurate testing ensures that only bacterial throat infections are treated with antibiotics, helping prevent misuse and resistance.

If you are unsure, testing services like those offered by Patient Access, which can identify if a painful throat is caused by strep bacteria rather than a virus can give you more clarity about your condition.

Antibiotic medications are usually prescribed to tackle the offending bacteria upon a positive diagnosis of a bacterial sore throat. It's a relieving step towards healing and preventing any further complications. Proper treatment is important to ensure strep bacteria are fully eradicated and to prevent recurrence or spread of infection. In addition to antibiotics, managing pain and fever with over-the-counter medications and staying hydrated can help relieve symptoms.

Penicillin

Penicillin was the first antibiotic ever discovered by Alexander Fleming in 1928 and remains effective against common streptococcal bacteria that cause throat infections.

Penicillin works by attacking the walls of the bacteria cells, which kills the bacteria causing the infection. It is taken as a pill or liquid suspension for 10 days to fully eradicate strep bacteria from the throat and prevent the recurrence of infection and illness.

Completing the full 10-day course of penicillin, even once symptoms improve, is critically important. This ensures the strep bacteria is completely eliminated from the body and prevents antibiotic resistance from developing. Follow-up throat cultures after treatment may be performed to confirm the infection has been cured.

Managing your symptoms with over-the-counter medications and keeping your body hydrated helps relieve discomfort while the antibiotic treatment runs its course. But penicillin remains the primary and most effective treatment for diagnosed bacterial throat infections.

Bacterial throat infections often spread through close contact, which can be concerning. However, by taking the following thoughtful precautions, you can reduce your risk and protect those around you:

• Practice diligent handwashing with plain soap and warm water for at least 20 seconds (you can sing Happy Birthday twice, so you don't need to count the seconds). This removes contagions that could enter the mouth and throat.
• Avoid close contact like kissing, sharing drinks or utensils, and exposure to coughs/sneezes from those with active throat infections. Limit contact until the illness has passed.
• Disinfect frequently touched common surfaces like doorknobs, countertops, desks, etc., using household cleaners effective against bacteria.
• Do not share personal items like towels, lip balm, etc., that could transfer bacteria from an infected person.
• Strive for adequate sleep and nutrition to support immune function, making you more resistant to infection. Stay hydrated.
• Remain home from school, work, or other activities when actively ill to contain spread.
• In some cases, if infections happen often, a doctor may suggest taking antibiotics as a preventive measure to protect against future illness.
• Keep children current on vaccinations like annual influenza shots to avoid vaccine-preventable bacterial infections.

While not fail-proof, diligent prevention measures can reduce bacterial exposure. However, prompt diagnosis and care remain essential if throat infection symptoms do develop.

While antibiotics remain the proper medical treatment for bacterial throat infections, some natural remedies can provide temporary symptom relief when used under the guidance of a healthcare provider. However, it's important to note that while they might provide symptomatic relief, they are not cures for bacterial infections:

Saltwater Gargling

Gargling with warm salt water can temporarily relieve pain and reduce inflammation associated with sore throats. Dissolve 1/2 to 1 teaspoon of table salt or sea salt in an 8-ounce glass of clean, warm water (that equals 236 ml or simply one cup of water). Gargle the solution for 30-60 seconds, allowing it to reach the back of the throat, then spit it out. Repeat gargling every 2-3 hours as needed for pain relief. The salt concentration should be mild, similar to tears, as too much salt can irritate the throat.

Throat Lozenges

Cough drops and throat lozenges containing numbing ingredients like phenol, menthol, or benzocaine can provide several hours of soothing, numb relief for throat pain when used as directed. Menthol also offers a cooling sensation. Look for lozenges formulated specifically for temporary throat pain relief and avoid excessive consumption.

Cold Treatments

Icing the throat with ice chips, popsicles, or cold drinks provides a numbing effect to reduce swelling and soreness. Additionally, specialised throat sprays applied to the back of the throat offer a cooling sensation, while gargling with very cold water can have a similar temporary soothing result. Apply cold remedies as needed for inflammation relief.

Soothing Teas

Warm teas containing ingredients like honey, lemon, liquorice root, marshmallow root, slippery elm, and others may temporarily help coat the throat and reduce painful swelling and inflammation. Honey and lemon provide extra antibacterial effects. Liquorice and marshmallow roots have special substances that form a soothing coating to help calm irritated tissues in the throat.

Apple Cider Vinegar

Diluting apple cider vinegar with warm water and gargling can help kill bacteria and temporarily reduce throat pain for some. Mix 1 tablespoon of apple cider vinegar into 8 ounces warm water and gargle for 30-60 seconds before spitting out. Rinse with plain water afterwards. Do not swallow the vinegar.

Turmeric Milk

Turmeric contains the anti-inflammatory compound curcumin. Mix 1/4 teaspoon turmeric powder into warm milk and drink once or twice daily to reduce swelling and discomfort. Be careful with staining. Those with dairy allergies can make turmeric tea instead.

Cloves

Cloves have pain-relieving and antibacterial properties. Place 1 whole clove in the mouth, gently biting to release oils, allowing it to sit near the sore throat area. Take care not to swallow. Repeat with new cloves as needed for numbing relief.

Related Reading

Sore throat - NHS (www.nhs.uk)

Sore throat (pharyngitis) - symptoms, treatments and causes | healthdirect