Most sore throats in 5-year-olds are viral and improve within 3 to 7 days. Antibiotics do not help viral sore throats. The Red Book advises not giving antibiotics unless group A strep testing is positive. Red Book 2021 Report of the Committee on Infectious Diseases, PHARYNGITIS section.

When to consider strep testing At age 5, strep throat is possible, especially with sudden sore throat, fever, tender neck glands, red/swollen tonsils or white patches, and no cough/runny nose. A clinician can perform a rapid strep test, sometimes followed by a throat culture if negative. If testing confirms strep, prescribed antibiotics such as penicillin or amoxicillin are standard treatment. CDC strep guidance states that confirmed strep should be treated, while viral pharyngitis should not receive antibiotics.

Seek urgent medical care now if there is trouble breathing, drooling or inability to swallow saliva, inability to open the mouth normally, stiff neck, severe one-sided throat pain/swelling, bluish lips, confusion, a new widespread rash with high fever, or signs of dehydration such as very little urine, no tears, or marked sleepiness.

Arrange a pediatric assessment within a day if fever lasts more than 3 days, throat pain is severe, there is a rash, or symptoms are not improving after several days.