DR. MOHLER: Sore throat? What you need to know
MOHLER’S MEDICATION MAXIMS
Free Press Health Columnist
STREP CLINICS AT MESA COUNTY HEALTH DEPT.
Location: 510 29 1/2 Road
8 a.m.-5 p.m. Monday
9 a.m.-5 p.m. Tuesday
8 a.m.-5 p.m. Wed.
8 a.m.-2 p.m. Thurs.
8 a.m.-noon Friday
The tickle in your throat has changed to pain. You are getting hoarse.
A.) Take Tylenol, gargle some salt water and try to forget about it? (Cost of 15 cents.)
B.) Call for an appointment to see your primary care physician? (A $80-$100 bill or a substantial co-pay.)
C.) Head over to the Mesa County Health Department for a throat culture? (A $20 bill, includes a prescription for an antibiotic if test is positive.)
How do you decide?
SORE THROAT FACTS
Antibiotics have NO effect on illnesses caused by viruses. Many antibiotics carry a 1 in 8 chance of causing diarrhea.
Most sore throats are caused by viruses, not Strep. Among kids with sore throats, who are tested, about 20%-25% will show Strep. For adults, the Strep rate is 5%-15%.
In spite of these Strep rates, studies consistently show that about 70% of sore throat patients walk out of their doctors’ offices with an antibiotic prescription. Remember that pleasing you, the patient, sometimes trumps science.
Kids under 3 years of age rarely get Strep and DO NOT need to be tested.
Adults and children with sore throats who also have cough, runny nose, hoarseness or mouth sores predictably have a viral illness and DO NOT need Strep testing.
Adults or kids with sudden onset of sore throat, swollen glands in the front of the neck, or pus on the tonsils are more likely to have Strep and probably should be tested, particularly if they have two or more of these additional symptoms.
WHY DO WE WORRY ABOUT STREP?
In the past in the U.S., rheumatic fever was a complication of Strep, but today it is truly an unusual event. Antibiotic treatment of Strep throat does decrease the chance of the rare complications of a throat abscess and kidney disease. The bottom line is that the overwhelming majority of patients with untreated Strep do not develop any of these complications.
Most sore throats can be managed at home with acetaminophen, salt water gargles (1 teaspoon of table salt dissolved in one cup of warm water) and time.
Those sore throat patients with sudden onset of symptoms, pus on tonsils, big swollen neck lymph glands and fever warrant a Strep test. Check with your primary care doc’s office to see if you can get a Strep test without seeing a caregiver, or head over to the Mesa County Health Department.
A small minority of patients with trouble breathing, increasing difficulty with swallowing or talking, and severe pain need to see a physician.
Dr. Mohler has practiced family medicine in Grand Junction for 38 years. He has a particular interest in pharmaceutical education. Phil works part-time for both Primary Care Partners and Rocky Mountain Health Plans. Email him at firstname.lastname@example.org.
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