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[Sticky] Strep Throat


Michael Gray MD JD
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✅ What telemedicine can do for sore throat / strep
🩺 Clinical evaluation

A clinician can assess:

Symptom onset and duration

Fever

Pain with swallowing

Cough absence (important for strep)

Swollen lymph nodes (by history)

Tonsillar exudates (via video, when possible)

Recent exposure to strep

Clinical decision tools (e.g., Centor or McIsaac criteria) are commonly used in telemedicine.

🧪 Testing coordination (key for strep)

Because strep throat requires confirmation, telemedicine can:

Order a rapid strep test at a lab, pharmacy clinic, or drive-through site

Sometimes arrange mail-in or in-clinic testing

Start treatment after a positive test

Some telemedicine programs may treat empirically in select high-risk cases, but testing is best practice.

💊 Treatment

Viral sore throat: supportive care (fluids, saltwater gargles, lozenges, NSAIDs)

Confirmed strep throat: prescribe antibiotics (e.g., penicillin, amoxicillin, cephalexin if appropriate)

Prescribe pain relief and throat sprays

Provide work/school notes

🚨 When in-person care is needed

Telemedicine is not appropriate if there is:

Trouble breathing or swallowing saliva

Drooling or muffled “hot potato” voice

Severe unilateral throat pain (possible abscess)

Neck stiffness or swelling

Rash with fever (scarlet fever)

Persistent symptoms despite antibiotics

🧠 Why telemedicine works well

Initial risk stratification is history-driven

Testing can be coordinated remotely

Treatment decisions follow clear guidelines

Red flags are easy to identify

⚠️ Important caveat

Antibiotics should not be prescribed for strep without testing in most adults and children — telemedicine providers who follow guidelines will require confirmation.

✅ Bottom line

✔ Yes — telemedicine can safely evaluate sore throat and manage suspected or confirmed strep throat, including ordering tests and prescribing antibiotics when appropriate.


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