Also Known As
Throat Culture
Culture, Throat
Rapid Strep Test
Rapid Antigen Detection Test (RADT)
Streptococcal Screen
Group A streptococcus (GAS)
Formal Name
Group A beta hemolytic streptococcus
This article was last reviewed on
This article waslast modified on
May 25, 2018.
At a Glance
Why Get Tested?

To determine if your sore throat is "strep throat" that is caused by group A streptococcus (GAS) bacteria

When To Get Tested?

When you have a sore throat that starts quickly and lasts more than a week and/or other symptoms such as a fever of 101° F or higher, or reddened throat and/or tonsils with white or yellow patches or streaks

Sample Required?

A swab rubbed against the back of your throat and tonsils

Test Preparation Needed?

None

You may be able to find your test results on your laboratory's website or patient portal. However, you are currently at Lab Tests Online. You may have been directed here by your lab's website in order to provide you with background information about the test(s) you had performed. You will need to return to your lab's website or portal, or contact your healthcare practitioner in order to obtain your test results.

Lab Tests Online is an award-winning patient education website offering information on laboratory tests. The content on the site, which has been reviewed by laboratory scientists and other medical professionals, provides general explanations of what results might mean for each test listed on the site, such as what a high or low value might suggest to your healthcare practitioner about your health or medical condition.

The reference ranges for your tests can be found on your laboratory report. They are typically found to the right of your results.

If you do not have your lab report, consult your healthcare provider or the laboratory that performed the test(s) to obtain the reference range.

Laboratory test results are not meaningful by themselves. Their meaning comes from comparison to reference ranges. Reference ranges are the values expected for a healthy person. They are sometimes called "normal" values. By comparing your test results with reference values, you and your healthcare provider can see if any of your test results fall outside the range of expected values. Values that are outside expected ranges can provide clues to help identify possible conditions or diseases.

While accuracy of laboratory testing has significantly evolved over the past few decades, some lab-to-lab variability can occur due to differences in testing equipment, chemical reagents, and techniques. This is a reason why so few reference ranges are provided on this site. It is important to know that you must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

For more information, please read the article Reference Ranges and What They Mean.

What is being tested?

The bacteria Streptococcus pyogenes, also known as group A beta-hemolytic streptococcus or group A streptococcus (GAS), causes "strep throat," the most common bacterial cause of inflammation and soreness of the back of the throat (pharyngitis). Strep throat tests identify the presence of these bacteria as the cause of a sore throat.

While most sore throats are caused by a virus and will resolve without treatment within a few days, some people with sore throats have strep throat. Strep throat is most common in children ages 5 to 15 years old. It is important that these bacterial strep infections be promptly identified and treated with antibiotics.

Strep throat is contagious and can spread when an infected person coughs or sneezes and other people come into contact with the droplets or mucus. Touching the face, eyes or mouth after touching something that has these droplets on it can spread the infection. The best way to avoid getting strep throat is to wash hands thoroughly and often and avoid sharing items like utensils or cups. A person who has a sore throat should wash their hands often and cover their mouth with a tissue or sleeve when coughing and sneezing.

If strep throat is not diagnosed and treated, secondary complications may develop, especially in children. These complications may include rheumatic fever, which can damage the heart, and glomerulonephritis, which affects the kidneys. Because streptococcal infections are routinely diagnosed and treated, these complications are rare in the United States now, but they do still occur.

A rapid strep test and/or a throat culture is used to diagnose group A streptococci as the cause of symptoms and allows the health practitioner to prescribe the proper antibiotics for treatment.

How is the sample collected for testing?

A health practitioner uses a tongue depressor to hold down a person's tongue and then inserts a special swab into the mouth and rubs it against the back of the throat and tonsils. The swab may be used to do a rapid strep test in a doctor's office or clinic, or it may be sent to a laboratory. A second swab may be collected along with the first one. This extra sample is used to perform a throat culture as a follow-up test, when necessary.

Is any test preparation needed to ensure the quality of the sample?

No test preparation is needed. The test should be performed before antibiotics are prescribed.

Accordion Title
Common Questions
  • How is it used?

    Strep tests are used to determine whether a person with a sore throat (pharyngitis) has strep throat, an infection of the throat and tonsils caused by the bacteria Streptococcus pyogenes, also called group A streptococcus (GAS).

    Most sore throats are caused by a virus and will resolve without treatment within a few days, but some people with sore throats have strep throat. It is important to diagnose and treat strep infections promptly with antibiotics because they are very contagious and secondary complications can develop, especially in children.

    A rapid strep test, also known as a rapid antigen detection test (RADT), can detect group A strep antigens. Results are available in 10-20 minutes. Recently, the U.S. Food and Drug Administration (FDA) approved molecular tests that can detect genetic material from group A strep bacteria in throat swab specimens in less than 8 minutes.

    If the results of the rapid test are positive, further testing is not needed and treatment can be started right away. If the rapid strep test is negative, a throat culture should be performed on children or adolescents to confirm the results and avoid missing infections that could lead to serious complications, such as rheumatic fever. A throat culture is more sensitive than the rapid strep test, but it may take 24-48 hours for results. According to 2012 guidelines from the Infectious Diseases Society of America (IDSA), confirmatory testing on adults is not usually recommended since adults have lower rates of strep throat and far lower risk of complications than children.

  • When is it ordered?

    A health practitioner will typically order this test when a person has a sore throat and other symptoms that suggest strep throat. There is a higher suspicion of strep when the affected person is a child and/or if the person has been in close contact with someone who has been diagnosed with strep throat. Individuals should see a healthcare provider and get tested when they have:

    • Sore throat that starts quickly and lasts more than a week, or recurrent sore throats
    • Fever of 101° F or higher
    • Reddened (inflamed) throat and/or tonsils with white or yellow patches or streaks
    • Tiny red spots at the back of the roof of the mouth
    • Difficulty or severe pain when swallowing
    • Headache, body aches
    • Nausea or vomiting
    • Tender and/or swollen throat or lymph nodes
    • Rash
    • Hoarseness lasting more than two weeks
    • Blood in saliva or mucus
    • Excessive drooling in young children
    • Symptoms of dehydration, such as excessive thirst, dry mouth, decreased urination

    In accordance with the 2012 Infectious Diseases Society of America (IDSA) guidelines, testing is not recommended when there are also symptoms more closely associated with a viral infection, such as:

    • Cough
    • Runny nose
    • Mouth sores

    Since strep is less common in children under the age of 3, IDSA advises against strep throat testing in this age group unless the child is considered at risk, such as when a family member has been diagnosed with strep throat. In general, the IDSA advises against the routine screening of asymptomatic people who have been in close contact with someone with a strep throat infection.

  • What does the test result mean?

    A positive rapid strep test indicates the presence of group A streptococci, the bacteria that cause strep throat. A negative rapid test indicates that the affected person probably does not have strep throat, but a throat culture may be performed for confirmation, especially among children and adolescents.

    If the throat culture is positive for group A streptococci, then the person tested does have strep throat. In rare cases, pharyngitis may be caused by group C or group G streptococci. These organisms will not cause a positive rapid test but can be detected by culture. If the culture is negative, then it is most likely that the sore throat is due to a viral infection that will resolve on its own.

  • Is there anything else I should know?

    Strep throat spreads from person-to-person through contact with respiratory secretions that contain the streptococcal bacteria. During influenza season, the early symptoms of influenza, such as fever, chills, headache, sore throat, and muscle pain, may mimic strep throat. To differentiate between strep and influenza, a rapid strep test and a rapid influenza test may be done at the same time.

    Most people with streptococcal pharyngitis would eventually recover without antibiotic treatment, but they will be contagious for a longer period of time and are at a greater risk of developing secondary complications.

    Strep throat is most common in 5 to 15 year olds. Some school children may be "carriers," persons who have the bacteria but who have no symptoms. Carriers can still spread the infection to others.

    Recent antibiotic therapy or gargling with some mouthwashes may affect the rapid strep test results.

    One note: the 2012 IDSA guidelines are voluntary and do not represent universal consensus in the medical community on when and how to use the strep test. They reflect current knowledge and expert opinion and are intended to assist in the diagnosis and management of strep throat.

  • How long does treatment for strep throat usually last?

    Ten to 14 days, depending on the antibiotic prescribed. Although your symptoms may improve or disappear before you have taken all of your antibiotics, you should complete your full course of treatment by taking all of the pills that were prescribed.

  • How long should I stay away from other people if I have a positive test result?

    You should complete at least 24 hours of antibiotics before close contact with others.

  • When can my child go back to school?

    Usually after one full day of therapy and absence of significant fever; however, a few small studies have found that children may return to school as soon as 12 hours after taking their first dose of antibiotic provided they no longer have a fever and their symptoms have improved.

  • If one child in my family has strep throat, is everyone going to get sick?

    Other family members, including adults, can be infected by the bacteria. The healthcare provider may test all family members who have sore throats and may test children under the age of 3. In most cases, it is not necessary to test other family members who do not have symptoms.

  • What can I do to prevent the spread of strep throat?

    The spread of strep throat can be reduced by good hand washing, especially after coughing and sneezing and before preparing food or eating. People with sore throats should be seen by a healthcare provider who can perform tests to find out whether the illness is strep throat. If the test result shows strep throat, the person should stay home from work, school, or daycare until 24 hours after taking an antibiotic.

  • I've had strep throat before and was treated with antibiotics. Can I get it again?

    Yes. Although antibodies may protect those who have had previous strep infections, there are so many different strains of this organism that being immune to all of them is unlikely. Therefore, someone could potentially get strep throat again and again. The best way to decrease the risk of transmission to others is to minimize close contact with others when ill and wash hands often and thoroughly with soap and water or alcohol-based hand scrub.

  • What is an ASO test and how is it used to detect a strep infection?

    Antistreptolysin O (ASO) is a blood test used to help diagnose a current or past infection with group A strep (Streptococcus pyogenes). It detects antibodies to streptolysin O, one of the many strep antigens. This test is rarely ordered now compared to thirty years ago. For an acute strep throat infection, the ASO test is not helpful; the rapid strep test or throat culture should be used. However, if a health practitioner is trying to find out if someone had a recent strep infection that may not have been diagnosed, this test could be helpful. In addition, it may be used to help diagnose rheumatic fever or glomerulonephritis, which occurs weeks after a strep throat infection when the rapid strep and throat culture would no longer be positive.

  • Do other group A streptococous infections occur?

    Group A streptococcus can also cause infections that occur separately from strep throat, such as impetigo and, rarely, more invasive conditions such as toxic shock syndrome or necrotizing fasciitis (the so-called "flesh-eating bacteria").

  • Are there other types of streptococci that can cause a sore throat?

    Group C and group G streptococci, normally found in animals, can occasionally cause pharyngitis in humans. However, these bacteria do not pose a risk for the serious secondary complications associated with group A streptococci. Antibiotic treatment for group A streptococci will be effective against these organisms as well.

View Sources

Sources Used in Current Review

Kahn, Z and Salvaggio, M. (2015 3 September, Updated). Group A Streptococcal Infections. Available online at http://emedicine.medscape.com/article/228936-overview through http://emedicine.medscape.com. Accessed on September 7, 2015.

Mayo Clinic Staff. (2012 20 December, Updated). Strep Throat. Available online at http://www.mayoclinic.org/diseases-conditions/strep-throat/basics/definition/con-20022811 through http://www.mayoclinic.org. Accessed on September 7, 2015.

US Centers for Disease Control and Prevention. (2014 20 October, Updated). Is It Strep Throat? Available online at http://www.cdc.gov/Features/strepthroat/ through http://www.cdc.gov. Accessed on September 7, 2015.

Medscape Medical News. (2015 2 April). Rapid Group A Strep Test Clears FDA. Available online at http://www.medscape.com/viewarticle/842544 through http://www.medscape.com. Accessed on September 7, 2015.

Lean W, Arnup, S, Danchin M, and Steer A. Rapid Diagnostic Tests for Group A Streptococcal Pharyngitis: A Meta-analysis. Pediatrics. 2014;134(4). Available online at http://pediatrics.aappublications.org/content/early/2014/09/02/peds.2014-1094 through http://pediatrics.aappublications.org. Accessed on September 7, 2015.

Alere i Strep A. [Package Insert]. Alere Scarborough, Inc., Scarborough, Maine. July 2015.

Medscape Medical News. (2015 2 September). Strep Throat: Treated Kids Can Return to School in 12 Hours. Available online at http://www.medscape.com/viewarticle/850338 through http://www.medscape.com. Accessed on September 7, 2015.

Sources Used in Previous Reviews

Thomas, Clayton L., Editor (1997). Taber's Cyclopedic Medical Dictionary. F.A. Davis Company, Philadelphia, PA [18th Edition].

Pagana, Kathleen D. & Pagana, Timothy J. (2001). Mosby's Diagnostic and Laboratory Test Reference 5th Edition: Mosby, Inc., Saint Louis, MO.

(2005 October 11). Group A Streptococcal (GAS) Disease (strep throat, necrotizing fasciitis, impetigo). CDC, Division of Bacterial and Mycotic Diseases [On-line information]. Available online at https://www.cdc.gov/groupastrep/index.html through http://www.cdc.gov.

Vincent, M., et. al. (2004 March 15). Pharyngitis. American Family Physician [On-line journal]. Available online at http://www.aafp.org/afp/20040315/1465.html through http://www.aafp.org.

Kazzi, A. and Wills, J. (2005 April 21, Updated). Pharyngitis. eMedicine [On-line information]. Available online at http://www.emedicine.com/emerg/topic419.htm through http://www.emedicine.com.

Gerber, M. and Shulman, S. (2004 July). Rapid Diagnosis of Pharyngitis Caused by Group A Streptococci. Clinical Microbiology Reviews, July 2004, p. 571-580, Vol. 17, No. 3 [On-line journal]. Available online at http://cmr.asm.org/cgi/content/full/17/3/571 through http://cmr.asm.org.

Homeier, B. (2005 September, Reviewed). Strep Throat. KidsHealth for Parents, Nemours Foundation [On-line information]. Available online at http://kidshealth.org/parent/infections/lung/strep_throat.html through http://kidshealth.org.

Pagana, K. D. & Pagana, T. J. (© 2007). Mosby's Diagnostic and Laboratory Test Reference 8th Edition: Mosby, Inc., Saint Louis, MO. Pp 912-913.

Forbes, B. et. al. (© 2007). Bailey & Scott's Diagnostic Microbiology, 12th Edition: Mosby Elsevier Press, St. Louis, MO. Pp 265-278.

Smith, D. S. (Updated 2008 September 3). Streptococcal screen. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/003745.htm. Accessed May 2009.

Sharif, I. (2008 November). Strep Throat. TeensHealth, The Nemours Foundation [On-line information]. Available online at http://kidshealth.org/teen/infections/bacterial_viral/strep_throat.html# through http://kidshealth.org. Accessed May 2009.

Nainggolan, L. (2009 March 6). AHA Updates Advice on Strep Throat, Preventing Rheumatic Fever. Medscape Today from Heartwire [On-line information]. Available online at http://www.medscape.com/viewarticle/589223 through http://www.medscape.com. Accessed May 2009.

Vorvick, L. (Updated 2009 March 14). Strep throat. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/000639.htm. Accessed May 2009.

(2009 February 26). Diagnosing, treating strep throat key to preventing rheumatic heart disease. American Heart Association News Release [On-line information]. Available online at http://americanheart.mediaroom.com/index.php?s=43&item=682 through http://americanheart.mediaroom.com. Accessed May 2009.

Mayo Clinic staff (2008 June 26) Strep throat. MayoClinic.com [On-line information]. Available online at http://www.mayoclinic.com/print/strep-throat/DS00260/DSECTION=all&METHOD=print through http://www.mayoclinic.com. Accessed May 2009.

(2012 September 10). Bad Sore Throat? It's Probably Not Strep, Most Likely Viral. IDSA [On-line information]. Available online at http://www.idsociety.org/2012_Strep_Throat_Guideline/ through http://www.idsociety.org. Accessed September 2012.

Shulman, S. et. al. (2012 September 9). Clinical Practice Guideline for the Diagnosis and Management of Group A Streptococcal Pharyngitis: 2012 Update by the Infectious Diseases Society of America. Clin Infect Dis. (2012) doi: 10.1093/cid/cis629. [On-line information]. Available online at http://cid.oxfordjournals.org/content/early/2012/09/06/cid.cis629.full through http://cid.oxfordjournals.org. Accessed September 2012.

Khan, Z. and Salvaggio, M. (2012 August 1). Group A Streptococcal Infections. Medscape Reference [On-line information]. Available online at http://emedicine.medscape.com/article/228936-overview through http://emedicine.medscape.com. Accessed September 2012.

Delgado, J. and Fisher, M. (Updated 2012 September). Streptococcal Disease, Group A - Group A, Strep. ARUP Consult [On-line information]. Available online at http://www.arupconsult.com/Topics/StrepA.html through http://www.arupconsult.com. Accessed September 2012.

Mayo Clinic staff (2010 June 26). Strep throat. Mayoclinic.com [On-line information]. Available online at http://www.mayoclinic.com/print/strep-throat/DS00260/DSECTION=all&METHOD=print through http://www.mayoclinic.com. Accessed September 2012.

Ben-Joseph, E. (Reviewed 2011 October). The Scoop on Strep Throat. KidsHealth from Nemours [On-line information]. Available online at http://kidshealth.org/kid/ill_injure/sick/strep_throat.html# through http://kidshealth.org. Accessed September 2012.

Pagana, K. D. & Pagana, T. J. (© 2011). Mosby's Diagnostic and Laboratory Test Reference 10th Edition: Mosby, Inc., Saint Louis, MO. Pp 939.

Choby B. Diagnosis and Treatment of Streptococcal Pharyngitis. Am Fam Physician. 2009 Mar 1;79(5):383-390. Available online at http://www.aafp.org/afp/2009/0301/p383.html through http://www.aafp.org. Accessed September 2012.

(May 2, 2012) Center for Disease Control and Prevention. Get Smart: Know When Antibiotics Work, Sore Throat. Available online at http://www.cdc.gov/getsmart/antibiotic-use/URI/sore-throat.html through http://www.cdc.gov. Accessed September 2012.

Ask a Laboratory Scientist

 

Your questions will be answered by a laboratory scientist as part of a voluntary service provided by one of our partners, the American Society for Clinical Laboratory Science (ASCLS). Click on the Contact a Scientist button below to be re-directed to the ASCLS site to complete a request form. If your question relates to this web site and not to a specific lab test, please submit it via our Contact Us page instead. Thank you.

Contact a Scientist