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Thread: Do you always give abx for strep?

  1. #1
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    Default Do you always give abx for strep?

    Ok I am kind of at my wits end with this strep thing. We are on case #3 since March of strep in the house. I am not sure what is going on but each time no one really seems sick. Back in March DD2 was tested because she had a rash on her hands while at a visit about to get vaxes (and DD1 had a confirmed case) and she tested + so no vaxes. The rash is eczema....

    This time DH went for a physical and tested + so he was put on abx. He had been complaining of a sore throat earlier in the week but thought it was allergies. DD1 was also complaining but then got very stuffy and we assumed it was allergies. Once DH came back with a + diagnosis and DD3 started with a stuffy nose I figured all 3 should be tested even though they were acting fine, no fevers and DD2 had no symptoms of anything.

    So I bring all 3 in today. I could tell the doc thought I was a bit crazy. He was shocked when all 3 came back positive. I wasn't! I knew it would because that is just how it has been. All 3 went home with abx.

    So what is going on here? Are we just never getting rid of it? Does it always need to be treated even if there are virtually no symptoms? Is strep something that is always in your body? Should it only be treated when a fever is present? I am tired of my kids being on meds plus i don't feel like they are even working. Unfortunately I know amoxicillin is what is usually used to treat strep and DD1 is allergic so she has been getting cephalexin. They gave that to all 3 this time and last time (well 2/3 last time).

    WWYD? Would you keep letting them prescribe abx? Would you only seek out the doctor when your child has a fever? Would you refuse meds for a child that has no symptoms? I guess the problem is if one is a carrier (I suspect DD2 is) but the others are not she will keep getting them sick. Still even "sick" isn't sick....just a stuffy/runny nose.
    Thing 1 (8), Thing 2 (5), Thing 3 (2)

  2. #2

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    My kids haven't had it but, without antibiotics its contagious. If my kids were to have yes, I would absolutely treat it with the doctor's RX for antibiotics even if
    they aren't in pain it will get rid of it so other people don't get it. I've had it twice in my life and its very painful IMO I am surprised they didn't have pain
    but, maybe they have a high pain tolerance or it just started. I am not sure if its always in your body though.
    *** Lindsay ***



  3. #3

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    I would certainly want it treated with antibiotics because untreated strep can lead to rheumatic fever, which can cause heart damage. Definitely not something to be messed with, in MY opinion. I had a friend in middle school/high school who had rheumatic fever. She was out of school for months.
    Lynne, Grandma to three beautiful girls and one handsome little man!


  4. #4

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    some people are strep carriers and will have a positive test no matter what. So I would not treat if they don't have fever and sore throat. The whole concept of strep carriage is kind of a grey zone; if they were my patients I would be consulting with someone from infectious disease to get a plan. But no, they don't need antibiotics for a positive test without symptoms of strep (fever/sore throat) in my opinion.

  5. #5
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    Quote Originally Posted by tapir View Post
    some people are strep carriers and will have a positive test no matter what. So I would not treat if they don't have fever and sore throat. The whole concept of strep carriage is kind of a grey zone; if they were my patients I would be consulting with someone from infectious disease to get a plan. But no, they don't need antibiotics for a positive test without symptoms of strep (fever/sore throat) in my opinion.
    Thank you for this. I have been upset with the constant script writing all winter and now again when even the doctor was surprised it was positive. I wish he would have thought more about it instead of just whipping out his prescription pad. I was telling him their history (as it was visible in their charts). I feel like no one is seeing the big picture here but me. I certainly don't want to be irresponsible and let something go that could be harmful to my children or others but something just isn't right here....

    I guess in the future I will be more mindful of the symptoms and more outspoken about treating when symptoms are present. The doc took all their temps and they were normal. None were complaining of sore throats. Even with DH - he was complaining of a sore throat earlier in the week but never had a fever and the sore throat went away. I am glad we are treating it this time especially since DH is + too. Hopefully we will just get rid of it completely. I guess I wont even take them to the pedi unless they have more serious symptoms in the future.....

    ETA: Can they spread strep to others when not showing symptoms?
    Last edited by macksmom; 06-01-2014 at 06:41 AM.
    Thing 1 (8), Thing 2 (5), Thing 3 (2)

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    Quote Originally Posted by tapir View Post
    some people are strep carriers and will have a positive test no matter what. So I would not treat if they don't have fever and sore throat. The whole concept of strep carriage is kind of a grey zone; if they were my patients I would be consulting with someone from infectious disease to get a plan. But no, they don't need antibiotics for a positive test without symptoms of strep (fever/sore throat) in my opinion.
    My SIL is a strep carrier and *always* tests positive . They only treat her with abx when she's symptomatic.

    My youngest had chronic thrush/yeast for the first 15months of his life despite adequate treatment (and an insane level of home measures trying to keep it under control ). Eventually his pedi sent him to an immunologist because she said it's abnormal for a healthy toddler (no paci or bottles) to continue to get thrush. The immunologist tested him for several immune deficiencies, but everything came back normal. He said that doesn't mean he *doesn't* have a deficiency that is preventing him from fighting off the thrush, but that it is "unspecified". So he wrote down "unspecified immune deficiency" as a dx, reassured us it is very likely something he will outgrow, and said to see him in 6months if he was still dealing with it. By then the thrush was gone...we still have occasional bouts with yeasty diaper/skin rashes, but nothing severe or unmanageable (responds to treatment).

    Anyway, just sharing because although we didn't end up with a specific diagnosis, seeing a specialist, having our concerns validated, and knowing the follow up was there if needed was very reassuring . It sounds like it's time to move beyond the pedi/pcp for you guys too.

    Praying you get some answers!!
    Dh (39) Me (37) 8bio 1adopted, 14 angels






  7. #7
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    Quote Originally Posted by kellyowens View Post
    My SIL is a strep carrier and *always* tests positive . They only treat her with abx when she's symptomatic.

    My youngest had chronic thrush/yeast for the first 15months of his life despite adequate treatment (and an insane level of home measures trying to keep it under control ). Eventually his pedi sent him to an immunologist because she said it's abnormal for a healthy toddler (no paci or bottles) to continue to get thrush. The immunologist tested him for several immune deficiencies, but everything came back normal. He said that doesn't mean he *doesn't* have a deficiency that is preventing him from fighting off the thrush, but that it is "unspecified". So he wrote down "unspecified immune deficiency" as a dx, reassured us it is very likely something he will outgrow, and said to see him in 6months if he was still dealing with it. By then the thrush was gone...we still have occasional bouts with yeasty diaper/skin rashes, but nothing severe or unmanageable (responds to treatment).

    Anyway, just sharing because although we didn't end up with a specific diagnosis, seeing a specialist, having our concerns validated, and knowing the follow up was there if needed was very reassuring . It sounds like it's time to move beyond the pedi/pcp for you guys too.

    Praying you get some answers!!
    Thanks. I have also been wondering if it has something to do with the quick in-office tests. I mentioned to the pedi if they still send it to the lab if it's positive and he said no that it usually comes back negative if they send it to the lab. To me that would mean it's really negative? But he said the office tests are super sensitive and better at detecting. Maybe they are TOO sensitive?! Maybe they are detecting it when it is not a problem? My friend says he kids never have a sore throat when diagnosed either....
    When I was young strep was very serious and very painful. Now it seems like a passing cold.

    I have also been wondering if perhaps we are just not getting rid of it bc DD1 can't have amox so whatever they are prescribing isn't working....

    All this is kind of in response to seeking further treatment. I am not sure if I need to if it's not a major problem - ie recurrent fevers, painful sore throats, etc.
    Thing 1 (8), Thing 2 (5), Thing 3 (2)

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    Quote Originally Posted by tapir View Post
    some people are strep carriers and will have a positive test no matter what. So I would not treat if they don't have fever and sore throat. The whole concept of strep carriage is kind of a grey zone; if they were my patients I would be consulting with someone from infectious disease to get a plan. But no, they don't need antibiotics for a positive test without symptoms of strep (fever/sore throat) in my opinion.
    I was thinking I had read this somewhere...Good to have it validated by a pediatrician!

    Hope you are able to enjoy an illness-free summer!

    ~ Cassie, mama to Madison (8), Ali (4) & Wesley (new dude!)


  9. #9
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    I was a strep carrier as a child, but my brother and sister weren't so they were always getting sick from me, but I always fine--but has pos tests. I took some kind of medicine for 30 days and have never had a positive test since then.
    Natalie [31] DH [40] 9/01, 1/06 NaturallyNatalie's Hair Accessories!

  10. #10

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    It is true that some people carry strep and are asymptomatic. Strep throat in those individuals should still be treated. According to what I've read people who aren't prescribed antibiotics are at a higher risk of rheumatic fever. Its rare but it happens. The severity of illness is not related to its ability to cause rheumatic fever. Strep can also be "cleared" from carriers with the right antibiotic treatment. I would go see an ENT to see what the next step should be.
    Last edited by Nurse2008; 06-02-2014 at 11:59 AM.

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