John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
The treatment for a sore throat depends upon the cause:
Viruses will run their own course and the infection usually will resolve when the body fights them off. Mononucleosis (mono) can take up to a month to resolve but there is no specific treatment for it.
Bacterial infections of the tonsils or adenoids are treated with antibiotics. Chronic infections may require surgery to remove the tonsils or adenoids.
Dry mouth caused by mouth breathing or smoking is treated by changing habits (quit smoking) or by changing sleeping positions. Home remedies such as lozenges and mouthwash may be tried. Mouth breathing at night may be a sign of other respiratory problems. Talk to a doctor about possible causes for nighttime mouth breathing.
Gastroesophageal reflux (GERD) is treated with multiple medications to decrease stomach acid. Talk to a doctor about treatment options.
Sinus drainage (post nasal drip) is treated with over the counter decongestants or nasal sprays.
Bacterial infections such as strep throat are treated with antibiotics including penicillin, azithromycin (Zithromax, Zmax), amoxicillin (Amoxil, Dispermox, Trimox), and levofloxacin (Levaquin).
Sore throat due to the yeast Candida (thrush) is treated with anti-fungal medications.
What if I have multiple recurrent episodes of strep throat?
There are a number of situations in which a child or adult can have recurrent positive strep tests.
The first, and most common, is that the strep bacteria were never eradicated in the first place. The person did not get all of the doses of the medication prescribed. Unless the affected person takes a full 5 to 10 day course of antibiotics, the strep throat will not clear. Even missing a dose or two can be a problem. The patient should take all medication exactly as prescribed, and finish all the medication, even if the sore throat has resolved.
Individuals may be asymptomatic carriers of strep (a person who has strep in their throats all the time as part of their normal bacteria, but without symptoms of a sore throat). It may be necessary to test close contacts of a person with recurrent episodes of strep to see if they are carriers.
All strep throat bacteria will be killed by penicillin. If penicillin does not cure strep throat, the affected person should see their doctor. In rare cases, other bacteria in the throat can secrete an enzyme (penicillinase) that breaks down penicillin. This can be overcome by using a drug that is resistant to this enzyme.