Dear Dr. Mom,
I have a situation with strep that is making me crazy! My 12 year old has had strep at least 12 times in the past 8 months. Each time we treat with antibiotics. We’re REALLY good about following the dosing directions. Yet, at least half the time, the first round of antibiotics doesn’t clear it up and we have to do it again with another type of antibiotic. We always have his throat swabbed again after the meds are done to be sure we beat it, but within 2-3 weeks, he has it again!
He already had his tonsils taken out – and that was before he’d ever had strep throat. Both his dad and I have had our throats swabbed and we come up clean. I’m concerned that he seems to be taking antibiotics all the time.
—Susan
This does sound very frustrating for you and your son. Twelve infections in that short amount of time does seem extremely excessive especially in light of his tonsillectomy and adherence to antibiotic treatment. With that being said, I do wonder why he keeps getting tested at the end of each antibiotic course. Is this because he remains symptomatic? Meaning, does he have continued sore throat and fever?
The reason I ask is because your son could be a carrier of the bacteria that causes strep throat. The bacteria, known as streptococcus pyogenes (or group A strep), can remain in the oropharynx (throat) of up to 20% of school age children. These “carriers” are often asymptomatic and repeat testing is generally unnecessary. In addition, these children do not need to be treated with additional antibiotics if they remain asymptomatic.
The only children who should be tested again for group A strep following treatment for strep throat are:
- Children who continue to have symptoms of strep throat following completion of antibiotic therapy.
- Children with a history of rheumatic fever (this is a complication of untreated acute strep throat)
- Those children whose household contacts are having recurrent and documented strep throat infections.
In the cases of the children above, they should be treated with a stronger antibiotic should their repeat strep test come back positive.
If your son falls in neither one of those categories (no history of rheumatic fever and no recurrent strep throat among household contacts) and he is asymptomatic at the end of treatment, he does not need to be re-tested for group A strep.
So, how can you know for sure if your son is simply a carrier?
- You can ask your son to be tested for strep during a time when he has no symptoms. This may have already been done. If his test was positive during an asymptomatic interval, then he is most likely a carrier.
- You can have your son’s ASO titers checked. This is a blood test. Typically, ASO titers are high during an acute infection. If his titers are very low, this points to him being a carrier. Keep in mind, this test is not necessary. It can be done if you and your doctor are still unsure of his carrier status.
The problem that group A strep carriers can run into during cold and flu season is that they can often have sore throats that are due to these viruses and not strep. If your son happens to get tested during this time and he is a carrier, he may mistakenly be diagnosed with strep throat and be treated yet again with antibiotics.
In order to distinguish a true strep throat infection versus a viral infection, keep in mind that strep throat usually causes severe sore throat, fever, headache, and sometimes stomach ache and nausea. There is typically the absence of viral and flu symptoms such as runny nose, congestion, cough, and/or body aches and fatigue.
Work closely with your son’s doctor. Ask him about the possibility of your child being a carrier of group A strep. If it is determined that your son is a carrier, don’t worry. Being a carrier is not a lifelong condition, nor is it a serious one. Carriers are unlikely to spread this bacteria to household contacts and they are not at a higher risk for developing complications associated with strep throat.
The bottom line is this: Stop having your son tested for strep throat if he is not having any symptoms. Realize that being a carrier of group A strep does not mean that he is contagious to those around him. He is only contagious if he is having an acute strep throat infection (fever, sore throat, etc).
I hope this helps you in your quest to solve your son’s strep throat dilemma.
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Wow! Really interesting question. My oldest daughter also gets strep all the time, every since the 1st grade. In fact it is the only illness she ever gets. She doesn't always have all the symptoms, but I know as soon as she gets one the rest are soon to follow.
Fortunately for us the antibiotics work well.
Hello,
I was wondering what antibiotics you have used for the strep throat that really worked??
Thank you,
Susan
I had no idea some people carry it always!
My daughter had two bouts of strep throat and some kind of viral infection with 103 fever and within a month! I'm definitely worried that her tonsils could be what's causing her problems.
If this child isn't a carrier, but truly getting recurring bouts of strep throat, I wonder if the problem is with his toothbrush. We've been very careful about replacing my daughter's toothbrush during her strep throat attacks. Not doing so could cause recurring infections!
@Cheryl D: Good point about taking measures to prevent true recurrences. Changing the toothbrush after a bout of strep throat is a good preventive measure.
Thank you for these great posts!
I'm the mom who wrote the original question. The reasons my pediatrician swabs him AFTER the antibiotic is finished are:
1. To see if he's a carrier. The pedi tells me that a negative strep shows that my son is not a carrier.
2. Because several times my son has gotten very sick again right after the end of his anitbiotic and we've needed to go on a second, stronger course of meds to really kick the strep.
We always change the toothbrush after my son has been on the antibiotic for 24 hours. We do not have any pets (I'm told that pets can be carriers). And, there have been times when my son had a sore throat, had a strep test, and it turned up negative. So – I'm thinking that he's NOT a carrier (right?)
Any further thoughts or suggestions?
Thanks for bringing this up, I went through a period of time in college with constant positive strep tests before an urgent care DR finally relayed this information to us.
To the mom with the original question: This isn't the answer you want to hear, but I went through a period of time where the exact same thing happened to me as a child. I had strep more times than I could count on one hand in one years time as a kid. Eventually we started the shots instead of oral antibiotics, for whatever reason that made a difference or it just got better. It's hard to know which it was. But it did eventually stop.
I'm sorry you and your kiddo are going through this. Strep is horrible stuff!
This is great advice here, Melissa!
I *always* had strep when i was little- & this post makes me wonder if I'm a carrier?
I think that this is so timely with so many sicks going aroundandaroundandanround right now. Thanks so much for the great info!
@SusanF: Sounds like you have a wonderful pediatrician working with you and your son. You are right, he may not be a carrier from the info you just provided.
Resistant strains of the strep bacteria are rare but possible. I wonder if he might benefit from the penicillin shot as @Amanda had to, next time he comes down with a case of strep?
I hope this phase in your son's life is short lived and I sincerely appreciate you sharing this question with us.
What an interesting post. I had no idea that a child could be a carrier and test positive for strep without really having the infection. Good to know how to handle situations like this. Thanks for the heads-up
I had strep throat once and it was horrible pain! I can't imagine how rough it would be to keep getting it 12 times in 8 months! Poor kid.
Thank you for your very informative post Melissa – I love that you do this every week!
My 11 yr old son has had strep 9 times in 12 months. He is on Cefdinir, 5th day, and still complaining of a raging sore throat. He is scheduled to have his tonsils and adenoids out on June 2nd, but I worry that if we don't find where he is getting it, it will continue even without tonsils/adenoids. I don't understand why he is in such pain after 5 days on such a strong antibiotic.
So glad I stumbled upon this post, and your blog, while doing a Google search for strep carriers. My 2 year old has had strep 4 or 5 times this year already, so we're looking into whether he, or I might be a carrier. We've both tested negative for it once, so I am still trying to figure out if he could still be a carrier, or if he's just unlucky and getting sick too much! I have bookmarked your blog though. Thanks for the info!
My son had his tonsils and adenoids out on June 2nd. He is 11. He was just diagnosed with strep for the 2nd time since school started. He took omnicef. He felt horrible the whole time on the antibiotics. Sore throat lasted almost the whole time as did stomach aches. Today they gave him a penicillin shot which they said would last for 1 month. We are going back to have him retested in 2 wks. He is NOT a carrier. We have had the dog and family tested. He has had several negative tests between episodes. He is so upset (as am I) that he went through the pain of having his tonsils and adenoids out and is still getting strep. ANYONE ELSE HAVE ANYTHING SIMILAR?
My daughter is 8 and had strep a few times a year up until last year when she had it 4 times, along with ear infections. She also has had negative swabs so I don’t think she is a carrier. She tends to get a stuffy head along with the strep. At the end of last year she had her tonsils/adnoids removed. She was a loud breather/snorer so I don’t think that surgery was a mistake. We are now a month and a half into another school year and she has strep for the second time now. Similar to the MOM story above. I’m at a loss of what to do..
My son had strep 9 times last yr before we had his tonsils/adenoids removed in June. He is still complaining of an intermittent sore throat and intermittent stomach ache 9 days after the pennicillin shot. He is very stuffy off/on also, but don’t know if that is because I stopped his allergy medicine to try and figure out if that had anything to do with it. We just had an environmental company come and check our house for recommendations to improve the quality of air that could be causing allergies, reducing immune system and his ability to fight infections, ie. strep. They recommended $77k worth of changes, plus new carpet ($9k), plus new vaccum cleaner ($500), new washing machine ($900+) etc. etc. I’m willing to do whatever to get my son healthy and stop the strep! Every time he looks at me and says his throat hurts, it breaks my heart!
Does your child have a lot of stomach aches also? My son sleeps with our dog. They recommended that he not do that too.
My daughter is 11 and this is her 2 battle with strep in 4 wks. She is also immune suppressed and takes weekly infusions so now they are wondering if she is a carrier. The swab 4 wks ago was negative but the culture came back positive. This time the swab was positive and still waiting on culture results. So, they started her on antibiotics AGAIN and are going to retest her next week, while on the antibiotic, to see if she tests positive again. If so, then it is on to 3-4 weeks of stronger antibiotic. Needless to say I can sympathize with the mom and her original question, it is very frustrating! My daughter has also gotten scarlet fever with it AGAIN as well and is fighting with the rash as well – nerve racking to say the least.
My son will be 4 next month & has had Strep at least 10 or 12 times since he was 2. I myself kept Strep as a teenager & always wondered if I was a carrier, & if so could I have passed it on to him? I have been debating on taking him to an ENT & seeing about having his tonsils removed (as I’ve heard this will help with the recurring Strep infections)?? I’m not sure what I should do, any input would be greatly appreciated!!
My son has also had several episodes of strep, Just recently his sister tested positive in a screening to see if there was a family carrier. They are both on antibiotics now. I have two questions. #1 If my daughter is a carrier and is treated with antibiotics, will that keep my son from getting strep? #2 If he gets it again, should his meds be changed for a different kind or stronger dose? He has been taking Z-pac since he developed a rash that we thought might be an allergic reaction, now I believe it was scarlet fever, as he has had that several times after this first rash.
[...] Strep Throat Dilemma [...]
My son is 2 1/2 he kept getting strep over and over before he was two. He was hospitalized a lot because of dehydration. He ended up getting his tonsils out right after he turned two. He had strep every month thought he was a carrier. But would he run a fever and have a red sore throat and even a stomach ache from being a carrier? He’s been treated with amoxicillin we found he is allergic. So they tried other stuff I’m not sure. Last couple times he had the shots in his legs to see if that helps. A yellow antibiotic. It seems to come back wks later. Why? I hated seeing him hurt and get shots and I.vs from this. Plz help. Thx
My 6 year old son had hs tonsils removed 3 years ago. He also has a penicillin allergy. Last week, he was diagnosed with strep, put on Zithromax, 24 hours after finishing it, he ad a fever and sore throat again. Another positive culture. Now he’s on omnicef and were on day 5… He still has a sore throat. He’s not a carrier, in fact, this is the first time we have ever dealt with strep. He had the tonsillectomy bc of recurring ear infections.
Anyone?? I’m beginning to worry
My 7 year old daughter had her tonsils and adenoids removed just before her third birthday. Poor little thing, only 5th percentile in weight, had strep every month and it was taking 2-3 rounds of antibiotics to cure an episode. She also had sleep apnea that scared the daylights out of me. After she had them removed she gained 10 pounds in 6 months and was much happier and healthier. Ever since she started kindergarten she gets strep at least once a year still. Lately, she has been getting step once a month. She knows immediately when she has strep now. Therefore, we get her to the doctor within hours of her first symptom and she suffers much less. The doc said if she gets it again that we will need to test family member and even possibly the dog.
I have been reading many of your posts and am thankful to hear of some suggestions. I haven’t come across anyone, however, with a similar situation, so I’m hoping to find someone who has at least a few similarities. I have five children, ages 13 down to 7, and four of the five have had their tonsils and adenoids out dating back seven to four years ago. We had not been to the doctor’s at all last school year. this year, however, between the five children, we have had 16 cases of strep, one in September and the remaining 15 between November, 2011 and now(May, 2012). Our dog has been tested, my husband and I have been tested and we all came up negative. The kids have had periods where they came up negative, so they are considered not to be carriers. Recently, four of the five finished their antibiotics, and because of the recurring strep, we tested them the following day, and they were all positive. We throw away their tooth brushes, their sports’ mouth guards, etc., and have been diligent with their not sharing anything. Ironically, they are at the point, that they are not always showing an symptoms at all — but the tests continue to come up positive. We have a scheduled appointment with an infectious disease doctor at CHOP in Philadelphia at the end of this month, but in the meantime, I am still researching as much as I can. The only coincidence is that our dog was diagnosed with Addison’s disease, which is an autoimmune disorder, where the cells of the adrenal glands are destructing, resulting in our dog not being able to produce natural steroids, a couple months before this all started. If I google strep with Addison’s, they are mentioned together in some infectious disease articles. Any insight, advice is greatly appreciated! appointment
I am in the same boat as many on here. My kidst are 3, 2 and 1 and we are battling recurrent strep. We throw away tooth brushes each time, but re-test keep coming positive even just a few days off meds. My 3 year old just tested positive again. Think I might give her shot this time. Yikes!
Each child has had a negative test at some point so dr says they are not carriers. So sick of giving my kids antibiotics. The damage that must be occuring to their immune systems. At least I have them on Probiotics now too. We have an apt with a local ENT in Cleveland next week. So hoping he can shed some light on things for us.