What are the best antibiotics for strep throat?

Reviewed by:
Angela DiLaura, NP
Clinical Informatics and Quality Manager
Last updated on December 7, 2021 UTC

We all get sore throats and swollen glands from time to time.

But how do you know when yours is that particular type of illness — strep throat — that demands special attention? And, if you have it, what types of antibiotics might you need to treat it?

Don’t worry — we’ll explain everything.  

What is strep throat and how do people get it?

Strep throat is a specific type of bacterial infection—group A Streptococcus, in medical parlance. 

That differs from other illnesses that give us sore throats and coughs, which are usually viral infections that don't need to be treated with antibiotics, and go away on their own.

Strep bacteria live in the nose and spread when an infected person coughs or sneezes and spreads respiratory droplets to other people. You can catch strep from an infected person if you:

  • Inhale the droplets.

  • Touch something the droplets have landed on — like a doorknob — and then touch a mucous membrane (like their eyes, nose, or mouth).

  • Share the same drinking glass or dinnerware with an infected person.

  • Touch an open sore that was caused by group A Strep.

What’s the best way to avoid getting strep throat?

Strep is pretty common, and most people will get it at some point in their lives. But there are some common sense ways to avoid it:

  • Wash your hands regularly and correctly.

  • If you’re sick, wear a mask to avoid spreading respiratory droplets.

  • Avoid prolonged contact with someone who is sick.

  • Don’t share drink glasses or food with a sick person.

If you practice good standard hygiene, it’ll go a long way toward reducing your chances of getting strep.

How do I know if I have strep throat?

In children, about 25% of sore throats are caused by strep. Adults have fewer strep infections, with strep causing about 10% of sore throats in adults. The only way to know for sure is to get tested. Testing is pretty fast and easy: a doctor or nurse will take a swab of your throat and test for group A Strep.

That said, there are some telltale symptoms of strep that may lead you to see a doctor:

  • Sore throat.

  • Pain swallowing.

  • Fever.

  • Red and swollen tonsils, sometimes with white spots.

  • Small red dots on the roof of your mouth.

  • Swollen lymph nodes (glands) in your neck.

Interestingly, strep often does not include symptoms like cough, runny nose, trouble speaking, or pink eye.

Some people don’t experience any symptoms at all, but can still spread strep throat by coming into contact with others and/or spreading respiratory droplets.

When do I need to see a doctor?

If you think you have strep throat, or if you’ve been in close contact with someone who has it, schedule an appointment with your doctor.

Do I need antibiotics?

It depends

If you have or are likely to have strep, your doctor will treat you to help you get better sooner, stop you from transmitting strep to others, and also to prevent the rare occurrence of strep infection developing into complications — like rheumatic fever, and heart, kidney, and nervous system disorders. Fortunately, those side effects are rare. 

Even if you are starting to feel better from a sore throat that was caused by strep, you still need treatment to prevent these possible complications. 

Your doctor will assess the risk that your sore throat is caused by strep, and decide if the chance is high and immediate treatment is warranted, or if you need testing to see if it is strep, or if it's unlikely to be strep. 

The main factors that make it more likely that a sore throat is caused by strep include: History of recent exposure to someone who tested positive for strep, fever more than 100.4 degrees F, tender swollen lymph nodes ("glands") in the neck, and white exudate or spots on the throat or tonsils. If you have at least 2 of these risk factors, your doctor may decide to go ahead and treat you without doing a test, or before any test results are back. 

One caveat is that if you have symptoms that suggest a viral infection — such as cough, runny nose, congestion, conjunctivitis, or sores in your mouth, then it is unlikely that your sore throat is caused by strep. 

How soon will they start working?

Antibiotics start working right away and you should be feeling better within one to two days. The sore throat will feel better right away if you gargle with salt water (½ tsp salt in 4 oz of warm water), or if you use throat lozenges (Cepacol, Ricola, Halls, etc.) 

If it’s been longer than two to three days and you’re still feeling under the weather, or if you are feeling worse, talk to your doctor to see if something else is going on.

What are the best ones?

The go-to antibiotics for strep throat are penicillin and amoxicillin. 

People who are allergic to penicillins may be prescribed a non-penicillin antibiotic, usually one of:

  • A cephalosporin (cephalexin, cefadroxil).

  • Clindamycin.

  • Azithromycin.

  • Clarithromycin.

Your doctor will select the right one for you. Always check with your doctor and take the full course of prescription antibiotics as recommended.

Can I get antibiotics over the counter?

No, not the kind that treat strep throat at least. All the medicines listed above are oral antibiotics, which means you need a prescription.

The good news is, HealthTap doctors can help. Keep reading to learn more.

Can an online doctor treat me for strep throat?

Yes! HealthTap is here to help.

Our online doctors can meet you via video consultation and evaluate you for strep throat,  order tests*, offer medical advice, and write prescriptions that are sent electronically to your nearest pharmacy. HealthTap members can compare costs at the nearest five pharmacies and save up to 75% off the cost of their prescriptions. Additionally, if you schedule an appointment with a primary care physician in our Virtual Primary Care clinic, you can text with your doctor for free after your appointment to discuss any questions or clarifications you may have.

Choose your doctor and schedule an appointment today to get started.

*You may need to travel to an in-person clinic if testing for strep is needed.


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