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Dr. Sarah Lallaman: Is it strep: To test or not to test?

Dr. Sarah Lallaman: Is it strep: To test or not to test?

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Dr. Sarah Lallaman

Sarah Lallaman, DO, is pediatrician, Winona Health

Think about this when you or your child wakes up with a sore throat, does your brain start the questioning process? It could be strep throat, right? Oh wait, isn’t a sore throat also a common sign of COVID-19? What about mono? Maybe the babysitter had mono. But then you remember daycare had a case of hand foot and mouth last week too. Then you start wondering if maybe you should go in and get the whole family tested for strep throat, just to be sure, right?

As healthcare professionals, this is a story my colleagues and I hear quite often. It is our job to sort out all of the details, do a close physical exam and perform the appropriate tests to determine how to get the best outcome for you or your loved ones.

When it comes to strep throat, it seems like it should be pretty straight forward, right? If you have a sore throat, you do the test and if it is positive you should take antibiotics and soon you will feel better. Well, it would be nice if it was that simple. Because we get so many questions about this, I thought it would be helpful to try to explain why it isn’t as clear cut as it seems. At Winona Health, we strive to provide high quality care based on sound medical advice and recommendations.

It’s important to know that up to 85% of sore throats are from viral infections or other causes like allergies or reflux. Strep throat is not a leading cause of a sore throat. While it is easy to test and rule out strep, there are concerns with testing everyone “just to rule it out.” First, many people are natural carriers of the bacteria strep – meaning they can test positive but it isn’t what’s causing their symptoms and they do not need to be treated for it. Secondly, the test is relatively expensive. And, lastly, because of COVID-19, test supplies are currently more limited, so it’s more important than ever to avoid using supplies unnecessarily.

It’s also important to not use medications unnecessarily. Part of providing the best care is avoiding antibiotic overuse and misuse. More people are becoming familiar with the disadvantages of antibiotic overuse and are therefore more understanding of why they may not get a prescription for an antibiotic. When it comes to treating a sore throat, by testing only those whose symptoms are more consistent with strep throat, we can target antibiotics to appropriate patients. If it’s likely that a virus or something else is causing that pesky sore throat, an antibiotic won’t help, and we want to avoid using one.

Looking back at my earlier days in medicine, I’m reflecting on how I thought strep throat was so straight forward! Education is key, and it is our job to share that information with you. I can assure you that we are here to make sure that you and your family are getting the care you need and deserve. This requires that we as healthcare professionals are armed with the right information, and it takes an understanding from our patients that we are all after the same goal: to help you or your child start feeling healthy again.

What strep throat typically involves:

What strep typically doesn’t involve:

Sore throat that usually starts quickly

Cough

Fever

Runny nose or congestion

Red swollen throat or tonsils

Hoarseness or loss of voice

Painful lymph nodes in the neck

Red or pink eyes

Dark spots on the roof of the mouth or uvula

Sarah Lallaman, DO, is a pediatrician at Winona Health

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