19/09/2026
Welp, we made it 2 days of school before Wolfie got strep throat. My resulting thoughts:
I’m VERY grateful antibiotics exist, obviously.
Buuut: In the U.S., the standard recommendation is to treat strep throat with abx. In other countries, the approach to sore throats is MUCH more conservative. In the Netherlands, they don’t even recommend strep tests—the guideline states that distinguishing bacterial from viral sore throats doesn’t change initial treatment. The reasoning here: sore throats usually resolve on their own and complications are so rare that you don’t need to identify every kid with strep. They DO recommend abx for patients with signs of severe infection or at high risk of complications. TLDR: a Dutch kid with the same symptoms as an American-kid-who-tests-positive will usually never be tested/given abx. And rheumatic fever is very rare in the Netherlands, just like it is in the rest of the Western world (this is the scary complication from untreated strep you’ve prob heard of).
There is also the possibility of PANDAS from strep, and I couldn’t find any data on whether this is more common in European children who are presumably walking around with untreated strep fairly often.
IMHO the benefit of the abx is: shorten the duration of the illness (Wolfie felt better after 1 dose, and the pain before was intense) + prevent the spread of strep.
In any event, we chose to get Wolfie tested after 2 days of what he described as the worst sore throat of his life, and to put him on the amoxicillin the dr prescribed. Which means now I’m trying to support his microbiome!
There’s good evidence that certain probiotics can reduce antibiotic-diarrhea in kids. Lactobacillus rhamnosus GG and Saccharomyces boulardii are the most well-studied. I’m also trying and mostly failing to get him to eat fermented foods.
Finally, a tip from you guys: If your kid needs liquid antibiotics, ask for a dye-free version! Apparently many pharmacies can do this, but I didn’t know so ours is gross and bright pink.
*I’m not a doctor and this is not medical advice*