Kids With Treated Strep Throat Can Return to School the Next Day: Study

Symptomatic children with a confirmed diagnosis of streptococcal pharyngitis (strep throat) who are treated appropriately with a dose of amoxicillin can return to school the next day without risking infection of other students, results of a new study suggest. This finding challenges national and state recommendations specifying that children with strep throat, even when treated appropriately, should stay home for at least 24 hours.

The authors of the study, published online ahead of print in Pediatric Infectious Disease Journal, investigated whether a single dose of amoxicillin administered to a symptomatic child with confirmed strep throat might allow the child to go back to school as little as 12 hours after the medication.

The study enrolled 111 school children with sore throats and a positive strep test result. After receiving a single dose of amoxicillin (50 mg/kg), the children returned 12 to 24 hours later for a follow-up strep test. On the morning of day 2, only 10 of the children still had a positive rapid-antigen detection test (RADT) result, confirmed by overnight throat culture. “Group A streptococci were not detectable on the day 2 throat specimen by RADT and also by culture in 91% of the study,” the authors wrote.

The researchers observed that a full dose of amoxicillin, even when given in the late afternoon to a child with strep throat, resulted in the non-detection of group A strep in 91% of the children the next morning. Based on these results, they concluded that “all children treated with amoxicillin for strep throat by 5 pm of day 1 may, if afebrile and improved, attend school on day 2” without putting other students at risk for infection.

The authors further note that changing policies that bar students with strep throat, even that has been treated, could save money, improve school attendance, and reduce the number of sick days that parents use to stay home with their child.

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Reference:

Schwartz RH, Kim D, Martin M, Pichichero ME A re-appraisal of the minimum duration of antibiotic treatment before approval of return to school for children with streptococcal pharyngitis