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Duration of antibiotic treatment of a sore throat

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

  • a 561-patient trial found that a seven-day course of penicillin is better at resolving symptoms of a streptococcal sore throat than a three-day course. Symptoms resolved significantly quicker - by half to one day
  • the use of penicillin caused an accelerated resolution of symptoms by 2.5 days in patients with group A streptococcal sore throat. In those patients with non-group A streptococcal sore throat there was an accelerated resolution of symptoms by 1.5 days
  • the prolonged (7-day) penicillin treatment appeared to be protective against the risk of abscess

NICE have suggested in management of sore throat (2):

Antibiotics for adults aged 18 years and over (a,b,c)

  • first choice
    • Phenoxymethylpenicillin 500 mg four times a day or 1,000 mg twice a day for 5 to 10 days

  • alternative first choices for penicillin allergy or intolerance

    • Clarithromycin 250 mg to 500 mg twice a day for 5 days
    • Erythromycin 250 mg to 500 mg four times a day or 500 mg to 1,000 mg twice a day for 5 days

a. see BNF for appropriate use and dosing in specific populations, for example, hepatic impairment, renal impairment, pregnancy and breastfeeding.

b. doses given are by mouth using immediate-release medicines, unless otherwise stated.

c. erythromycin is preferred in women who are pregnant.


  1. BMJ. 2000;320(7228):150-4
  2. NICE (January 2018).Sore throat (acute): antimicrobial prescribing

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