Recurrent Strep Throat: What To Do When Strep Comes Back

Sore throats are a common rite of passage for growing kids. However, when a sore throat recurs with sudden fever and painful swallowing, it can be genuinely frustrating for families. 

Strep throat is a frequent culprit behind these sudden illnesses. Group A Streptococcus bacteria cause strep throat, which accounts for roughly 20% to 30% of sore throats in school-aged children.

While infections can occur year-round, they spike in late fall, winter, and early spring. During these cooler months, kids spend more time indoors in close contact at school and daycare, allowing bacteria to spread rapidly through respiratory droplets.

At Forest Pediatrics, led by board-certified pediatrician Murray Fershtman, MD, our team works closely with families across The Woodlands and Montgomery, Texas, to evaluate and manage pediatric illnesses, including repeated bouts of strep.

Understanding how strep is diagnosed and treated

You can't diagnose strep throat by visual inspection alone because viral sore throats often look identical to bacterial infections. We perform a simple swab of the back of the throat and tonsils. A rapid strep test yields results within minutes. If that test comes back negative but symptoms strongly point toward strep, we send a throat culture to a lab to ensure we don't miss an infection.

Once we confirm a strep infection, we prescribe antibiotics. Antibiotics shorten illness duration, reduce symptom severity, and prevent rare complications such as rheumatic fever. 

Most children aren't contagious and can safely return to school or daycare after 24 hours of antibiotics, provided their fever has resolved. It's critical to finish the full course of medication even if your child feels completely healthy after two days.

Why strep throat keeps returning

Recurrent strep throat is generally defined as having seven or more documented episodes in a single year, five episodes per year over two consecutive years, or three episodes per year over three consecutive years. Several distinct factors explain why strep throat returns in certain children:

• Incomplete antibiotic courses
• Antibiotic resistance or failure
• Exposure to asymptomatic carriers
• Re-infection from personal items
• Anatomical factors

However, you can take steps to prevent many of these causes.

Steps to prevent recurrent infections

Stopping the cycle of repeated strep requires a proactive approach at home alongside targeted medical care. Here are effective measures to lower your child's risk:

Replace toothbrushes

Throw away your child's toothbrush 48 hours after starting antibiotics and buy a new one.

Disinfect personal items

Wash water bottles, retainers, pacifiers, and hard plastic toys thoroughly in hot water or the dishwasher.

Practice diligent hand hygiene

Teach your child to wash their hands with soap and water for at least 20 seconds, especially before eating and after coughing.

Screen household contact

If strep keeps circulating through your home, we may recommend testing other family members to identify potential asymptomatic carriers.

Discuss specialist care

For persistent, severe, recurrent infections that disrupt school and sleep, a consultation with an ear, nose, and throat specialist to evaluate the need for a tonsillectomy might be appropriate.

If you're concerned about your child's sore throat or persistent infections, contact Dr. Fershtman today. We have two convenient offices in The Woodlands and Montgomery, Texas.