sore throat

sore throat

Sore throat is the symptom the patient presents. Some doctors feel uncomfortable that without antibiotics a few patients may risk the complications.

A review concluded that (1):

antibiotics are unnecessary for most patients with sore throat as it is a self-limiting condition, which resolves by one week in 85% of people, whether it is due to streptococcal infection or not
serious complications are rare
the Centor criteria may be useful to predict patients who are at higher risk of Group A beta-haemolytic streptococcus (GABHS) and complications, who may benefit from antibiotics
- in patients with tonsillitis who are unwell, and have three out of four of these criteria, the risk of quinsy is 1:60 compared with 1:400 in those who are not unwell
if antibiotics are clinically indicated, phenoxymethylpenicillin is an appropriate first choice (adult dose: 500mg two to four times a day for 10 days)
patients given antibiotics are more likely to reattend if they have another similar infection
a delayed prescription, for use after three days if symptoms are not starting to resolve or are getting significantly worse, may be more appropriate for some patients
offer advice and reassurance, and recommend analgesics for symptom relief in all patients

As most patients with a sore throat do not see a doctor it is worth asking why they came.

Reference:

Last reviewed 03/2020

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