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Dr. Chrysoula I. Liakou MD, PhD
- Treated online: Yes, usually. Video assessment of your throat, with antibiotics when the signs point to strep.
- Signs of strep: a sudden sore throat with fever, swollen tonsils with white patches, tender neck glands and no cough or runny nose.
- Antibiotics: they shorten strep throat by about a day and lower the risk of complications; most sore throats are viral and do not need them.
- Contagious: until you have taken antibiotics for 24 hours and your fever has gone; without antibiotics it can spread for two to three weeks.
- Emergency: call 112 if you are struggling to breathe, drooling or unable to swallow your own saliva.
Do not book a video appointment if you cannot swallow your own saliva or are drooling, your voice has become muffled, you cannot open your mouth fully, breathing is difficult, or the pain is severe on one side of your throat. These can signal an abscess or an airway problem and need emergency care. Call 112 if breathing is affected.
Can an online doctor treat strep throat?
Yes. Strep throat is diagnosed mainly from how the illness started and what your throat looks like, and both work by video. The doctor asks about fever, cough and how fast it began, looks at your tonsils with the light from your phone, and checks your neck glands with you. When the signs point to strep, the doctor can prescribe an antibiotic. Severe one-sided pain, drooling or difficulty breathing needs emergency care instead.
How an online consultation helps with strep throat
- A proper look at your throat: With a phone torch and the camera close to your mouth, the doctor can see swollen tonsils, white patches and the red, spotty palate that strep often causes.
- Antibiotics only when they help: The doctor scores your symptoms with the same checklists used in clinics, so you get antibiotics when strep is likely and are spared them when it is not.
- Complications ruled out: One-sided swelling, trouble opening your mouth and a muffled voice are checked first, because they point to an abscess that needs a hospital.
- Clear advice on spreading it: You leave knowing when you stop being contagious, when you can go back to work, and how to protect the people you live with.
What the doctor checks in an online strep throat consultation
The consultation follows a fixed order, and the emergency signs come first. The doctor asks about:
- Airway and abscess signs: drooling, a muffled voice, trouble opening your mouth, one-sided swelling or difficulty breathing.
- The strep checklist: fever in the past 24 hours, pus or white patches on the tonsils, how quickly you came for help, how inflamed the tonsils look, and whether you have a cough or a runny nose. Doctors use scores such as FeverPAIN and Centor to weigh these.
- Rash, ears and sinuses: a fine red rash that feels like sandpaper suggests scarlet fever, and earache or facial pain can mean the infection has spread.
- Your medicines and allergies: especially any penicillin allergy, pregnancy, and medicines that interact with antibiotics.
- Who you live with: close contact with young children, and anyone at home who is pregnant, older or unwell.
Before the call, find a bright light, such as your phone torch or a window, and a spoon handle if you have one, to hold your tongue down. Take your temperature if you have a thermometer.
Strep throat symptoms
Strep throat is a throat and tonsil infection caused by group A streptococcus (Streptococcus pyogenes), also called Strep A. It causes only a minority of sore throats in adults, usually estimated at 5 to 15%, but it is the one most likely to benefit from antibiotics. Typical symptoms are:
- a sore throat that starts suddenly and hurts when you swallow
- a fever of 38°C or higher
- red, swollen tonsils, often with white patches or streaks of pus
- swollen, tender glands at the front of the neck
- small red spots on the roof of the mouth
- headache, and sometimes nausea or stomach pain
What is usually missing matters as much: strep rarely causes a cough, a runny nose, a hoarse voice or red, watery eyes. Those point to a virus. Some people also develop a fine red rash that feels like sandpaper; that is scarlet fever, caused by the same bacteria.
What does strep throat look like?
In a mirror, with a torch, strep throat usually shows bright red, swollen tonsils, often with white patches or streaks of pus, and sometimes tiny red spots, called petechiae, on the roof of the mouth. The glands at the front of the neck can feel swollen and tender. A viral sore throat usually looks red without pus. A clear photo taken in good light helps the doctor see the same signs.
Strep throat or a viral sore throat?
Most sore throats are viral and settle within a week without treatment. No single sign proves strep, but the pattern does. The more signs in the strep column, the more likely antibiotics are to help.
Swipe sideways to compare →
| Sign | More likely a virus | More likely strep |
|---|---|---|
| How it starts | Gradually, often with a cold | Suddenly, over hours |
| Cough and runny nose | Usually present | Usually absent |
| Fever | Mild or none | Often 38°C or higher |
| Tonsils | Red, without pus | Swollen, with white patches or pus |
| Neck glands | Slightly swollen, or not at all | Swollen and tender at the front of the neck |
| Voice and eyes | Hoarse voice, red or watery eyes | Voice normal, eyes clear |
| Rash | Usually none | Sometimes a sandpaper rash (scarlet fever) |
In some countries a pharmacist or doctor can take a throat swab for a rapid strep test, which gives a result while you wait. A positive test confirms strep; a negative one makes it unlikely. Where no test is available, the doctor relies on the symptom scores, which is what most European guidelines recommend for adults.
How long does strep throat last?
Without treatment, strep throat usually improves within about a week, as most sore throats do. With antibiotics, most people feel noticeably better within two to three days, and the fever often settles within 24 to 48 hours. Antibiotics shorten the illness only by about a day, but they also lower the risk of complications such as quinsy and ear infections.
Once you have taken antibiotics for 24 hours and your fever has gone, you are unlikely to pass strep on and can usually go back to work. Without antibiotics, you can stay contagious for two to three weeks. The contagious calculator works out your likely contagious period from the day your symptoms started.
What causes strep throat, and how do you catch it?
Strep throat is caused by group A streptococcus bacteria. They spread through close contact with someone who has the infection, and through the droplets of their coughs and sneezes, so strep often passes between people who live together. Illness usually starts 2 to 5 days after contact. Some people carry the bacteria without feeling ill and can still pass them on.
Who is most likely to get strep throat?
Strep throat is most common in children aged 5 to 15: around 3 in 10 children with a sore throat have strep, against about 1 in 10 adults. Among adults, parents of school-age children and adults who are often around children are at higher risk. Crowded places, such as schools, nurseries, shelters and military training camps, help it spread. A recent cold or flu, open sores or wounds, and a weakened immune system also raise the risk of Strep A infections.
How to avoid catching or spreading strep
- Wash your hands often with soap and water.
- Cover your mouth and nose when you cough or sneeze, and put used tissues in the bin straight away.
- Do not share cups, cutlery or food with someone who has strep, and wash their dishes after they use them.
- Keep cuts and wounds clean and covered.
Strep A season in Europe
Strep throat usually peaks in winter and early spring, and some years bring a surge. In late 2022, several European countries, including France, Ireland, the Netherlands, Sweden and the UK, reported a rise in invasive Strep A infections and scarlet fever, mostly in children under 10. In England, 4,622 cases of scarlet fever were notified between mid-September and mid-November 2022, against an average of 1,294 for the same weeks of the previous five years. The World Health Organization linked the rise to an early start to the season, more respiratory viruses and people mixing again after a period of low Strep A circulation during the COVID-19 pandemic. The UK reported no increase in antibiotic resistance.
Is strep throat dangerous? Complications to know
Usually not. Most strep throat clears without problems, and antibiotics lower the risk of complications. A few are worth knowing, because they change what you need to do:
Quinsy (an abscess beside the tonsil)
Severe pain on one side of the throat, difficulty opening your mouth, drooling and a muffled “hot potato” voice suggest an abscess next to the tonsil. It needs urgent draining in hospital and cannot be treated online. Read more on the tonsillitis page.
Ear and sinus infections
Earache or facial pain during or after strep throat can mean the infection has spread. These are usually assessed and treated online.
Invasive strep A infection
Rarely, the same bacteria get into the blood or deep tissues. Warning signs are a high fever with severe muscle aches, pain in one area that is far worse than it looks, red, hot, spreading skin, or feeling very unwell, confused or faint. These need emergency care.
Rheumatic fever and kidney inflammation
These immune reactions are now rare in Europe. Swollen, painful joints or dark, cola-coloured urine one to three weeks after strep throat need a doctor’s review.
Which strep throat treatment might the doctor recommend?
Treatment follows the pattern of your symptoms and the emergency signs. This is the decision framework the doctors use, aligned with NICE and European guidance on sore throats.
Swipe sideways to compare →
| What you have | Likely first step | Suitable for online care? | When in-person care is needed |
|---|---|---|---|
| Sore throat with a cough and runny nose, few strep signs | Pain relief and self-care; no antibiotic | Usually yes | If it is worsening after a week, or warning signs appear |
| Some strep signs, mild illness | Self-care, sometimes a back-up antibiotic to start only if you are not better in a few days | Usually yes | If you get worse quickly or cannot swallow fluids |
| Many strep signs: fever, pus on the tonsils, no cough, fast onset | A course of a penicillin antibiotic, or another antibiotic if you are allergic | Usually yes | If you are no better after two to three days of antibiotics |
| Sore throat with a sandpaper rash | Assessment for scarlet fever; antibiotics | Usually yes, with photos of the rash | If the rash comes with feeling very unwell or confused |
| Severe one-sided pain, trouble opening the mouth, muffled voice | Possible quinsy: drainage in hospital | No | Emergency department now |
| Strep throat several times a year | Review of the pattern; ear, nose and throat referral if it keeps returning | Assessment and referral | Tonsil surgery is planned in person |
Not sure whether your sore throat is strep? A doctor can tell you in one consultation.
See available times →Treatment options for strep throat
What you can do yourself
- Take paracetamol or ibuprofen for the pain and fever, at the dose on the pack. Ibuprofen does not suit everyone, including people with a stomach ulcer, kidney problems or heart failure, or anyone who is pregnant.
- Drink plenty, even if swallowing hurts; cool drinks and ice lollies can be easier.
- Gargle with warm salt water, or use throat lozenges or a numbing throat spray from the pharmacy.
- Rest, and stay away from work and other people until you have had 24 hours of antibiotics and no fever.
Prescription treatment
A prescription is never issued without a consultation. When the signs point to strep, the doctor may prescribe a penicillin antibiotic, usually for 5 to 10 days, or another antibiotic such as clarithromycin if you are allergic to penicillin. Take the whole course, even when you feel better after a few days. If the doctor prescribes, use the prescription at a pharmacy near you.
What does not help
Antibiotics do not help a viral sore throat, and taking them “just in case” brings side effects such as diarrhoea and thrush without any benefit. Steroid tablets are not a routine treatment for a sore throat.
Special situations
Strep throat in pregnancy
Penicillin antibiotics are considered safe in pregnancy, and paracetamol is the usual choice for pain and fever. Avoid ibuprofen unless a doctor advises it. Tell the doctor how many weeks pregnant you are.
Strep throat that keeps coming back
A second episode soon after the first can mean the course was not finished, a different bacterium, or a carrier at home. If you have several confirmed episodes a year, the doctor can review the pattern with you and refer you to an ear, nose and throat specialist.
Strep throat while travelling
Penicillin antibiotics are widely available in European pharmacies, though the brand names differ. Strong pain relief and plenty of fluids matter more than usual on a long journey, and flying is best avoided while you have a high fever.
Children
Mobi Doctor consultations are for adults aged 18 and over. A child who is unwell needs a paediatrician or a local doctor in person, and emergency signs in a child mean 112.
When strep throat is treated online, and when you need in-person care
Treated online: a sore throat with or without strep signs, a suspected scarlet fever rash, recurring sore throats that need a plan, and advice on whether antibiotics would help.
In-person care: suspected quinsy or an abscess, any difficulty breathing or swallowing saliva, signs of invasive infection, dehydration, and tonsil surgery.
When to get in-person care
Call 112 or go to an emergency department now for:
- difficulty breathing, a high-pitched noise when breathing in, or drooling because you cannot swallow your saliva
- severe pain on one side of the throat with difficulty opening your mouth or a muffled voice
- a high fever with severe muscle pain, red, hot, spreading skin, or feeling confused or faint
Get medical advice the same day for:
- being unable to keep fluids down, or passing very little urine
- no improvement after two to three days of antibiotics
- a sore throat with a widespread rash and fever
How Mobi Doctor works
- Book a time that suits you: daily 7am–11pm CET. You can see a doctor over video, usually within 15 minutes. No subscription, and the exact price is shown before you pay.
- Speak to a licensed doctor about your sore throat: describe how it started, show your throat on camera with a bright light, and mention any penicillin allergy.
- Leave with a plan: what to do, what to take and for how long, and which signs mean you should be seen in person. If the doctor prescribes, use the prescription at a pharmacy near you.
No sign-up needed
Not sure it’s strep throat? Tick every symptom you have to see each condition page that mentions it. It finds the right page, not a diagnosis: a doctor gives you that on a video call.
Tap the body — an area or a point — to browse symptoms anywhere
Similar symptoms, different condition? Tonsillitis can start the same way. Compare them, or look up any other symptom in the full symptom checker.
Frequently asked questions about strep throat
What is strep throat?
Strep throat is a throat and tonsil infection caused by group A streptococcus bacteria, also called Strep A. Around 1 in 10 adults with a sore throat have it, and it is more common in children. It usually starts suddenly, with a painful throat, a fever and swollen tonsils, and it is one of the few sore throats that antibiotics help.
What does strep throat look like?
Strep throat shows bright red, swollen tonsils, often with white patches or streaks of pus, and sometimes tiny red spots on the roof of the mouth. The glands at the front of the neck are often swollen and tender. A cough, a runny nose or a hoarse voice point to a virus instead.
How do I know if I have strep throat?
Strep throat usually starts suddenly, with a painful throat, a fever of 38°C or more, swollen tonsils with white patches and tender glands at the front of the neck. A cough, a runny nose or a hoarse voice point to a virus instead. A rapid strep test or a throat swab confirms it, and where no test is available a doctor uses symptom scores such as FeverPAIN or Centor.
Is strep throat contagious?
Yes. Strep spreads through close contact and through droplets from coughs and sneezes, and illness usually starts 2 to 5 days after contact. Once you have taken antibiotics for 24 hours and your fever has gone, you are unlikely to pass it on. Without antibiotics, you can stay contagious for two to three weeks.
How can I avoid catching or spreading strep throat?
Wash hands often, do not share cups, cutlery, toothbrushes or towels, cough and sneeze into tissues, clean surfaces, and keep away from others until you have taken antibiotics for 24 hours and your fever has gone; replace your toothbrush after the first 2 days of antibiotics so you do not reinfect yourself. There is no vaccine against strep throat, and people who get it repeatedly are sometimes checked for a carrier in the household.
How long does strep throat last?
Without antibiotics, strep throat usually improves within about a week. With antibiotics, most people feel noticeably better within two to three days. If you are no better after two to three days of antibiotics, see a doctor again.
Can strep throat go away without antibiotics?
Often, yes. Like most sore throats, strep throat usually clears within a week on its own. Antibiotics shorten it by about a day and lower the risk of complications such as quinsy, which is why doctors offer them when strep is likely.
How can I get rid of strep throat fast at home?
There is no overnight cure. When the signs point to strep, an antibiotic helps you recover sooner: most people feel noticeably better within two to three days, and the fever often settles within 24 to 48 hours. Pain relief, plenty of fluids, salt-water gargles and rest ease the symptoms in the meantime.
Which antibiotic treats strep throat?
A penicillin antibiotic is the usual treatment for strep throat, typically for 5 to 10 days. People who are allergic to penicillin are usually given another antibiotic, such as clarithromycin. The doctor chooses the medicine and the length of the course for you.
Can you have strep throat without a fever?
Yes. Fever is common but not universal, especially in adults or if you have taken paracetamol or ibuprofen. Pus on the tonsils, tender neck glands and the absence of a cough still point to strep.
What is the difference between strep throat and tonsillitis?
Tonsillitis means inflamed tonsils, from any cause; most tonsillitis is viral. Strep throat is the bacterial form, caused by group A streptococcus, and it usually affects the tonsils too. Antibiotics help strep throat but not viral tonsillitis.
Can an online doctor prescribe antibiotics for strep throat?
Yes, when your assessment points to strep. After a video consultation the doctor can prescribe an antibiotic, and you can use the prescription at a pharmacy near you. If your sore throat is viral, the doctor explains what will ease it instead.
When is strep throat an emergency?
Call 112 or go to an emergency department if you have difficulty breathing, are drooling because you cannot swallow your saliva, have severe pain on one side of the throat with difficulty opening your mouth, or a high fever with severe muscle pain or spreading red skin.
- Sore throat (acute): antimicrobial prescribing (NG84), NICE, National Institute for Health and Care Excellence, 2018.
- Guideline for the management of acute sore throat, ESCMID Sore Throat Guideline Group, Clinical Microbiology and Infection, 2012.
- Antibiotics for treatment of sore throat in children and adults, Spinks A, et al. Cochrane Database of Systematic Reviews, 2021.
- Strep A, NHS, National Health Service (UK), reviewed 7 January 2026.
- Group A Streptococcus: guidance and data, UK Health Security Agency, updated 21 November 2025.
- About strep throat, CDC, US Centers for Disease Control and Prevention, 15 January 2026.
- Increased incidence of scarlet fever and invasive Group A Streptococcus infection: multi-country, WHO, World Health Organization, Disease Outbreak News, 15 December 2022.
This page is for information only and is not a substitute for a medical consultation. Guideline links are provided for transparency; treatment decisions are made with your doctor.
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