Streptococcal infections - Treating streptococcal infections

Treatment for a streptococcal infection will vary depending on whether it is a minor or invasive strep A infection, or a strep B infection in a newborn baby.

Minor strep A infections will often clear up on their own. In some cases, your GP may prescribe a short course of antibiotics.

Invasive strep A infections and strep B infections can be much more serious and require emergency treatment with injections of antibiotics.

These treatments are described in more detail below.

Minor strep A infections

Throat infection

To help relieve symptoms:

• avoid food or drink that is too hot, as they could irritate your throat
• avoid smoking and smoky environments
• gargle regularly with warm, salty water to help reduce any swelling or pain

Paracetamol or non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen may be used to control any pain and fever. However, there is some evidence to suggest that NSAIDs can increase the risk of an invasive infection. This may be due to NSAIDs masking more severe symptoms, or delaying the immune system's response to infection.

Antibiotics are not recommended for throat infections since most are due to viruses, not streptococcal infections. Antibiotics will do little to speed up your recovery time and can cause side effects such as nausea, vomiting and diarrhoea.

In addition, using antibiotics to treat minor ailments can make them less effective in the treatment of life-threatening conditions.

Antibiotics are usually only recommended if you are more vulnerable to the effects of a throat infection due to having a weakened immune system or a serious health condition such as heart disease.

In such circumstances, a 10-day course of a penicillin class of antibiotics is usually prescribed.

If you are prescribed an antibiotic, it is important to finish the course even if you feel better. If you are allergic to penicillin, another antibiotic called erythromycin may be used.

Read more about the treatment of throat infections.

Skin infections

Impetigo can be treated using antibiotic cream.

Cellulitis is a more deep-rooted type of skin infection, so will require a course of antibiotic tablets.

Read more about the treatment of impetigo and cellulitis.

Inner ear infection

Four out of five cases of inner ear infection clear up within a few days without the need for treatment.

Over-the-counter (OTC) painkillers, such as paracetamol and ibuprofen may be used to control the symptoms of inner ear infection (pain and fever). Aspirin should not be given to children younger than 16.

Antibiotics are not recommended for the reasons discussed above unless the symptoms are particularly severe or  worsen with time.

Read more about the treatment of otitis media.

Sinusitis

If your symptoms of sinusitis do not resolve within seven days your GP will often prescribe a short dose of antibiotics.

Over-the-counter painkillers such as paracetamol, ibuprofen or aspirin can be used to relieve a headache, high temperature and any facial pain or tenderness.

Read more about the treatment of sinusitis.

Invasive infection

Invasive strep A infections (with the possible exception of pneumonia) are regarded a medical emergency. Therefore, if you develop this type of infection, you are likely to be admitted to hospital. You may need to be placed in an intensive care unit (ICU).

The ICU will help support any affected body function, such as breathing or blood circulation, while medical staff will focus on treating the infection.

The infection will be treated using intravenous antibiotics (injected directly into a vein). Intravenous antibiotics usually have to be given for 7 to 10 days.

If there is an identifiable source of infection, such as an infected wound, it has to be treated. This is known as source control.

Source control could involve:

• draining the pus from an infected wound
• surgically removing infected or dead tissue

Strep B infections

Health professionals use a preventative approach to deal with strep B infections. This means trying to identify babies who have an increased risk of being born with a strep B infection.

As a precaution, mothers of high-risk babies can be given injections of antibiotics (intravenous antibiotics) during labour.

Alternatively, the baby can be given antibiotics shortly after birth.

Known risk factors that may mean you need to have injections of antibiotics during labour include:

• having given birth to a previous baby with a strep B infection
• if strep B is found in your urine during urine tests carried out for other purposes, such as checking if your bladder and kidneys were functioning normally
• if strep B is found during vaginal and rectal swabs carried out for other purposes, such as checking if you had an infection inside your vagina (vaginosis)
• if you have a high temperature during labour
• if you go into labour prematurely
• giving birth more than 18 hours after your waters have broken

If your baby develops a strep B infection after birth, they will need to be treated with intravenous antibiotics.