What is the next step if you suspect bacterial pharyngitis?

When bacterial pharyngitis is suspected, particularly group A Streptococcus (the most common bacterial cause of pharyngitis in children), it is essential to confirm the diagnosis before initiating treatment. Performing a rapid strep antigen test or a throat culture helps to identify the presence of the bacteria, which informs the decision to use antibiotics.

Starting antibiotics without confirmation can be unnecessary and contributes to the issue of antibiotic resistance. Observation and reassurance might not adequately address the potential for complications associated with untreated bacterial infections, such as rheumatic fever or suppurative complications. Prescribing an antihistamine is typically more relevant for viral infections or allergic rhinitis rather than for bacterial causes.

Thus, obtaining a rapid strep antigen test or throat culture is the most appropriate next step to ensure an accurate diagnosis and guide effective treatment. This step supports a targeted approach to management and helps prevent the complications and spread of bacterial pharyngitis.