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Dr. Andrew Rynne
Dr. Andrew Rynne

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Suggest treatment for fever blisters and strep throat

Answered by
Dr. Sandip Kabra

General & Family Physician

Practicing since :2009

Answered : 3078 Questions

Posted on Thu, 12 Nov 2015 in General Health
Question: Hi I am a healthy 37 year old female with good oral hygiene and no history of cold sores or fever blisters. This week I've had a terrible case of strep throat, confirmed with a strep test after high 102-103 degree fevers nightly and white patches on my tonsils and a few ulcers on my throat. I've taken 3 doses of antibiotics (Amoxicillin) and have seen an improvement in the swelling of my tonsils but I am still feverish (more like 101) and have a hard time swallowing still. The awful thing is my gums are also very red, hurt/ache and I have some mouth sores on the sides of my tongue, roof of my mouth, near my teeth etc. it feels like when you bring your mouth and pizza and the skin is sensitive for a few days this is been going on all week now and started at the same time as the strep outbreak. Is this typical and when can I expect to start feeling better? It's been extremely painful to eat and drink anything.
Answered by Dr. Sandip Kabra 47 minutes later
Brief Answer:
Need to take complete course of antibiotics rather than just 3 dose.

Detailed Answer:
Welcome to health care magic,

I have read your whole query and will be answered by me.

Sore throat with fever is actually a upper respiratory infection (pharyngitis, laryngitis, epiglotitis or may be tonsillitis.

Your mouth and tongue soreness with red gums are typical symptoms seen in upper respiratory infection (especially with streptococcal bacteria) but there is no need to be worried as it will also get resolved with proper and complete course of antibiotic with other supportive treatment.

As you had already confirmed it as a streptococcal throat infection then complete and appropriate antibiotic dosage would be effective here.

If I would have your treating doctor,I would like to give,

1) Complete antibiotic course with sufficient dosage like you are taking amoxicillin 850 mg twice daily,I would prefer to give amoxicillin with clavulanic acid (500+125 mg) three time daily for minimum 5 to 7 days complete course.

You have taken only 3 doses of amoxicillin and felt little improvement after that but it might not be sufficient to kill all the streptococcal bacteria,that is why it is advisable to go for complete course of treatment despite you feel well after initial dosage of antibiotics.

As it is a prescription drug,you can discuss with your treating doctor before acting upon. I am sure you symptoms will subside once you will complete the whole course of antibiotic treatment.

Apart from antibiotics,you should take symptomatic medications like pain killer with anti-pyretics like paracetamol 500 mg three times daily or ibuprofen is also effective but again 200 mg dosage is lesser rather you should take 400 mg with same frequency which is available over the counter

Antihistamines like levocetrizine or benadryl if you have a dry cough or cold.

Nebulization with saline and warm salt water gargles for mouth sores (stomatitis) can also be effective for symptomatic relief.

Take multivitamins like vitamin B complex with folic acid daily once.

I would expect you will start improving with initial 1 or 2 days dosages but again I would say not to stop the antibiotic course, rather you complete it and most probably your symptoms will not reappear.

Hope this will help you,feel free to ask if you have more questions.

Thanks and Regards,

Above answer was peer-reviewed by : Dr. Prasad
Follow up: Dr. Sandip Kabra 1 hour later
Thank you very much for all of the information I really appreciate it. Glad to know the gum and mouth sores are not that unusual after all. I did have one question though. I had mentioned that I am taking quantity three 200 mg ibuprofen every six hours. so does this mean I should be taking quantity three 400 mg ibuprofen every six hours?thank you very much again for your reply.

Just to further clarify that means I'm taking 600 mg approximately four times per day.
Answered by Dr. Sandip Kabra 13 minutes later
Brief Answer:
No,take 400 mg ibuprofen three times.

Detailed Answer:
Thanks for your appreciation.

I mean that you should take ibuprofen 400 mg 1 tablet three times daily which would be sufficient instead of 600 mg three times.

In case if fever does not subside with 400 mg ,then you can take 600 mg dosage three times daily.

The maximum dosage of ibuprofen for an adult is 800 mg per dose or 3200 mg per day.So,no need to be worried about over dosage.

Hope it will clear now.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

The User accepted the expert's answer

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