If you have strep throat, the most important thing you can do is get tested and start antibiotics as soon as possible. Strep is a bacterial infection that won’t resolve reliably on its own, and untreated cases can lead to serious complications. While you wait for antibiotics to work, there’s plenty you can do at home to manage the pain and speed your recovery.
Get Tested Before You Assume It’s Strep
Strep throat and a regular viral sore throat can feel very similar, but they require completely different approaches. A viral sore throat will clear up on its own. Strep needs antibiotics. The only way to know for sure is a test.
Doctors use a rapid strep test that takes about 10 minutes and catches roughly 99% of true strep cases. If the rapid test comes back negative but your symptoms are suspicious, your doctor may send a throat culture to a lab, which takes a day or two but serves as the gold standard.
Certain combinations of symptoms make strep more likely. Doctors look for fever above 100.4°F, swollen and tender lymph nodes at the front of the neck, white patches or swelling on the tonsils, and the absence of a cough. If you have all four, there’s roughly a 57% chance it’s strep. If you have zero or one, the odds drop to about 7 to 12%. Notably, if you do have a cough, runny nose, or other cold-like symptoms, a virus is the more likely culprit.
Start Antibiotics and Finish the Course
Penicillin or amoxicillin is the standard treatment. Your doctor will prescribe a course that typically lasts 5 to 10 days. Research has found that a 5-day course can be just as effective as a 10-day course, sometimes with shorter symptom duration, but follow whatever your doctor prescribes. If you’re allergic to penicillin, alternatives are available.
You’ll likely start feeling noticeably better within 2 to 3 days, but don’t stop taking your antibiotics early just because you feel fine. Stopping too soon can allow the bacteria to bounce back and increases the risk of complications.
When You Stop Being Contagious
Once you’ve been on antibiotics for 12 hours, you’re generally no longer contagious. Public health guidelines typically recommend staying home from work or school for at least 24 hours after starting treatment, though research suggests that children treated with antibiotics by 5 PM can safely return to school the next day if they’re fever-free and feeling better. The conservative approach is to wait a full 24 hours, especially if you still feel rough.
Without antibiotics, strep remains contagious for two to three weeks, even after symptoms start fading.
Managing Pain and Eating Comfortably
The sore throat from strep can be intense, especially in the first couple of days. Over-the-counter pain relievers like ibuprofen or acetaminophen help reduce both pain and fever. Throat lozenges and sprays with a numbing agent can provide short-term relief between doses.
Cold foods and drinks tend to feel the best. Ice chips, popsicles, smoothies, and frozen fruit can help numb your throat. Room-temperature foods are also easier to tolerate than anything hot. Use a straw if drinking is painful.
Stick to soft, moist foods that don’t require much chewing or scratch your throat on the way down. Good options include:
- Proteins: scrambled eggs, meatballs, tuna or chicken salad (without raw veggies), tender ground meat, tofu
- Dairy: yogurt (skip the granola), cottage cheese, milkshakes, ice cream
- Starches: mashed potatoes, pasta with sauce or gravy, oatmeal or hot cereal, pancakes soaked in syrup
- Fruits: ripe bananas, applesauce, canned or cooked fruit without skins or seeds
- Soups: broth-based soups and stews with soft noodles and tender vegetables
- Desserts: pudding, custard, gelatin, mousse
Avoid crunchy, acidic, or spicy foods. Toast, chips, citrus juice, and tomato-based sauces will aggravate your throat. If carbonated drinks appeal to you, let them go flat first to reduce the sting of the bubbles. The most important thing is to keep drinking fluids throughout the day, even if eating feels like a chore. Dehydration makes everything worse.
Preventing Spread at Home
Strep spreads through respiratory droplets, so wash your hands frequently, cover coughs and sneezes, and avoid sharing cups, utensils, or towels. If possible, use a separate bathroom while you’re still contagious. If that’s not an option, wipe down shared surfaces regularly.
Replace your toothbrush within 24 hours of starting antibiotics. Bacteria can linger on the bristles and potentially reintroduce the infection. Until you swap it out, you can soak your brush in hydrogen peroxide for 10 to 15 minutes, then rinse it thoroughly with hot water. Store it upright in open air rather than inside a closed container, which traps moisture and encourages bacterial growth. Don’t microwave or boil it, as that can damage the bristles and release chemicals from the plastic.
If you wear a retainer, night guard, or dentures, soak them in a sanitizing solution daily while you’re sick and give them a thorough cleaning once you’ve recovered. Keep toothbrushes separated from other family members’ brushes. If you have kids, a color-coding system prevents accidental swaps.
Why You Shouldn’t Skip Treatment
Most people recover from strep throat without any lasting effects, but untreated strep can trigger rheumatic fever, a serious inflammatory condition that typically develops one to five weeks after the initial infection. Rheumatic fever can damage the valves of the heart, and severe cases may require heart surgery. It’s rare in the United States today precisely because antibiotic treatment is so widely available, but the risk is real when strep goes untreated.
Untreated strep can also lead to kidney inflammation, abscesses around the tonsils, and spread of the infection to the blood or other tissues. These complications are uncommon but entirely preventable with a simple course of antibiotics. If you’ve been diagnosed, filling that prescription is the single most important thing you can do.