Symptomatic bacterial strep throat in toddler: antibiotics?

[orthodoxjay1]

What's the current thought on this? General recommendations online are to treat with antibiotics to prevent complications. But antibiotics cause complications. Would it be reasonable, e.g., to wait a couple of days after onset to see if condition improves? (N.B. that I understand that Reddit is not a reputable source of medical advice.)

 

[southernyankee]

@orthodoxjay1 Your post has a very vague statement:

“But antibiotics cause complications”

Please elaborate, what complications do antibiotics cause? Are you concerned about the specific kind (penicillin?) or the child’s age?

 

[ramonguitar]

@orthodoxjay1 Untreated strep throat can lead to scarlet fever. Most people don’t get scarlet fever anymore because antibiotics are used to treat strep throat before it turns into scarlet fever.

Edit: left untreated, scarlet fever can be deadly. It’s much easier to treat strep throat with a quick course of antibiotics than to deal with SF and it’s complications.

 

[iowakid8401]

@ramonguitar As someone whose toddler just developed scarlet fever, it is TERRIFYING. We were out of town, he had a fever but no other symptoms, and suddenly overnight developed insane hives, rash, and swelling, and it was an immediate ER visit. Scariest 36 hours of my life waiting for those antibiotics to take full effect

 

[ramonguitar]

@iowakid8401 My little brother had it when he was 3 (I was 6). I remember my mom being so afraid. She’s even a nurse, but didn’t realize he had strep before it became scarlet fever. She thought it was just a bad cold.

 

[veilmenacex]

@iowakid8401 I had scarlet fever when I was 6. I still remember the hallucinations I had because my fever was so high.

 

[platinum202]

@ramonguitar It can also cause lifelong problems, like kidney disease and arthritis.

 

[jluponeage]

@orthodoxjay1 No, it’s not reasonable, unless you want to be dealing with rheumatic fever. Antibiotics can have some complications, yes, but give your toddler some yogurt and other fermented foods and protect their heart valves.

 

[thatmimosagrove]

@orthodoxjay1 I don’t say this to scare you, but people literally die from untreated strep. Yes, antibiotics can have side effects or adverse effects on gut health, but untreated strep can be far more devastating.

 

[nichola1970]

@orthodoxjay1 I understand there’s a big concern for antibiotics but with strep, you don’t wanna mess around. If you know your child has it you’d probably already be prescribed an antibiotic. There’s a time and a place to worry about too many antibiotics but this ain’t it. You’re not going to repeatedly give antibiotics for the same thing over and over in this case. (I’m doing a little thesis on antibiotic stewardship and the big problem is not following guidelines appropriately.)

 

[lukefromthebible]

@orthodoxjay1 Strep infection may definitely go away on its own

But your kid may develop rheumatic fever, which leads to chronic lifelong heart problems

Strep is treated with regular old pennicilin, you dont even need amything broad spectrum

Proven strep = antibiotics no two ways about it

 

[beauty4ashes13]

@orthodoxjay1 If you're looking for reputable medical advice, ask over at r/askdocs. They're independently verified.

As a non doctor medical provider, I would strongly encourage you to weigh the risks and benefits of either approach.

• The risks of not treating strep have been covered by others here. There's a reason child and infant mortality dropped so dramatically after the discovery of antibiotics.
• The risks of the antibiotics themselves are minimal and might include some diarrhea, easily remedied with probiotics.
• The benefits of not taking antibiotics are... avoid possible diarrhea? Anything else you're specifically worried about?
• The benefits of taking antibiotics are: avoiding your child developing a systemic strep bacterial infection and all the many, well documented and dangerous complications therein.

I don't believe the possible benefit of avoiding the antibiotics come remotely close to outweighing the risks. I personally wouldn't throw those dice if it were my child.

 

[mrseme]

@orthodoxjay1 Untreated can also cause kidney issues like Post-Streptococcal Glomerulonephritis.

https://www.cdc.gov/groupastrep/diseases-public/post-streptococcal.html

I’m sure your dr would advise you the risk of antibiotic complications are significantly less than the risks of untreated strep.

 

[mrseme]

Also, strep is extremely painful as an adult, nobody should suffer with symptoms longer than they have to.

 

[jonnyalliance]

@orthodoxjay1 Google rheumatic fever. My dad has life long cardiac issues because of untreated strep when he was a toddler.

 

[dancequeen12]

@orthodoxjay1 Personally I would treat it with antibiotics due to the risk of complications everyone else mentioned, IF it was up to me. My actual comment is just to say that guidelines do differ between countries on this topic. My toddler got a rash that I was suspicious could be from strep (because that can happen sometimes) And they flat out refused to even test her for strep. I’m not sure it WAS strep but it could have been. She was too young to tell me about specific symptoms like a sore throat so even she was sick the few days prior I have no idea if it was a sore throat or what. Just fever and fussy. Mind you this rash went on for like a week and a half (no fever but just would not go away). They don’t routinely test for strep here (Finland) and thus the majority of cases likely don’t get treated either…. Personally that makes me super nervous (and avoid antibiotics like the plague - I have a whole PhD on the human gut microbiome) but it is what it is

 

[mathewmark1988]

@orthodoxjay1 Here is an article that goes against what most commentators are saying. I am an ER doctor and we recently had this discussion as a group. Part of it depends on where you live. Rheumatic fever in America in current times is basically non existent. The risk of allergic reaction to antibiotics is also high. My son had strep which was treated with Amoxicillin and he had a deadly allergic reaction and ended up in the ICU for 3 days. Could I go back, I would have just let his body fight it. That is anecdotal of course. Anyway, it’s an interesting article no matter your views.

https://rebelem.com/patients-strep-throat-need-treated-antibiotics/