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Date of last update: 10/12/2017.

Forum Name: Other infections

Question: Chronic Strep Treatment

 PatientX - Sun Sep 16, 2007 5:13 pm

I am a 60 year old male in generally good health, currently living mostly in Mexico.

I was very healthy for over a year - not even a cold. Then I felt a slight sore throat and was given a liquid Septicin (Amoxicilin) - of which I tookonly 4 of seven days, because I had to travel by air to the US.

I felt better for a few days, then slight soreness returned. A US doctor prescribed a one dose cypro that would get rid of strep, just in case, but without a culture. A few good days and then it returned.

A Mexican doctor did a culture to confirm and prescribed Combined Benezetacil (3 penecilins) three times every 28 days. After a week, I have good and bad days. Throat is very red with coating. I don't see improvement. Should I? Should I be concerned about anything - dose, failure to respond, ...?

Thank you,
 Dr. Chan Lowe - Sun Sep 16, 2007 10:05 pm

User avatar Hi PatientX,

Strep throat is generally very responsive to antibiotics. Currently, the Group A strep that causes the infection is thought to be essentially 100% sensitive to amoxicillin.

There are some patients, however, that continue to test positive for the bacteria, even after treatment. In these cases it becomes a difficult question. There is a certain percentage of people that will be carriers of the bacteria-that is, the bacteria will live in their throat but not be causing a problem. When this is the case, if the throat is cultured it will be positive, even if it isn't the strep bacteria that is causing the infection.

I would recommend a few things for you. First, I would suggest having your throat cultured and sensitivities run on the bacteria just to make sure that the antibiotics you are being treated with are effective. Second, I would recommend you have your throat cultured for viruses, particularly the Ebstein-Barr Virus, that can mimic strep throat.

Do you have a cough? If so, it is very unlikely to be strep throat. Strep classically will cause a fever, ill feelings and a severe sore throat without cough.

If it is determined that you are a carrier of the strep bacteria be sure that your doctors know this when you present with sore throats so they can be sure your symptoms line up with true strep infections rather than another illness.

Best wishes.

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