Strep Throat (Strep A) in Ireland — Symptoms, Treatment, When to Test

What is strep throat?

Strep throat is a bacterial infection of the tonsils and pharynx caused by Group A Streptococcus. It is one cause of sore throat — most sore throats are viral and do not need antibiotics.

Symptoms suggesting bacterial strep

• Sudden severe sore throat without cough
• Fever > 38°C
• Swollen, tender lymph nodes in the neck
• White or yellow patches on tonsils
• Headache and abdominal pain (especially in children)

The Centor / FeverPAIN score

Clinicians use scoring tools to estimate strep likelihood. A high-score sore throat with classical features benefits from antibiotics; a low-score, cough-and-cold-like sore throat does not.

Treatment

First-line: phenoxymethylpenicillin for 10 days. If allergic to penicillin: clarithromycin. Symptoms typically improve within 24–48 hours. Complete the full course even if you feel better — to prevent rare complications (rheumatic fever, post-streptococcal glomerulonephritis).

Invasive Group A Strep — be alert

Most strep throat is straightforward. Rare invasive disease (sepsis, severe skin infection, toxic shock) requires emergency assessment. Red flags: very high fever with confusion, rapidly spreading skin redness, severe joint pain, or a child who is floppy and unresponsive — call 999/112.

When to consult online vs in person

Uncomplicated symptomatic adults and older children with a classic picture can be assessed online. Children under 3, immunocompromised patients, anyone with breathing difficulty or stridor, or anyone unable to swallow saliva should be seen in person.

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