After my most recent column, a question was asked as to whether we had to treat strep throat. The answer is not as clear cut as one would think as it depends on how much risk, no matter how small, one wants to take.
Strep throat is self-limited and resolves within a few days, even without treatment. The arguments for treatment include faster resolution, prevention of complications such as a peritonsillar abscess, reduced time period of being contagious, and prevention of rare complications such as rheumatic fever.
Antibiotics shorten symptom duration by about 16 hours.
Antibiotics do reduce the incidence of acute rheumatic fever. However, in industrialized nations like the US, it has largely been controlled It is estimated that 3,000 - 4,000 patients must be treated with antibiotics to prevent one case of rheumatic fever in developed nations.