When are antibiotics needed for a sore throat?
Sore throat (pharyngitis) is very common. It is usually caused by a viral infection or less commonly, a bacterial infection.
In addition, you may have:
- A hoarse voice
- A mild cough
- A high temperature (fever)
- A headache
- A feeling of wanting to be sick (nausea)
- Tiredness
- Swollen glands in your neck
- Pain when you swallow.
The soreness tends to worsen over 2 to 3 days and then gradually goes within a week, though in about 10% of cases the soreness may last longer than that.
What is the best treatment for a sore throat?
- Doing nothing may be a sensible option- many throat infections are mild and get better by themselves.
- Plenty of fluids: it is tempting not to drink very much if it’s feeling painful to swallow. But you may become dehydrated, particularly if you also have a high
temperature (fever). Dehydration can make headaches and tiredness much worse. So it’s important to maintain good fluid intake. - Painkillers and anti-inflammatories can help ease symptoms.
- Various throat sprays and lozenges can be bought in pharmacies or supermarkets, and may give some relief also
What about antibiotics?
- Antibiotics are usually pointless, because most sore throats are caused by viruses, and antibiotics do not work against viral infections.
- Even if it is a bacterial infection, your immune system is often able to clear it without the need for medication.
- It is also important to remember that antibiotics can cause side-effects such as diarrhoea, rashes, thrush and stomach upset. Therefore, doctors do not prescribe antibiotics for most sore throats.
Signs of a bacterial infection
If 3 or 4 of these symptoms are present it is more likely that a throat infection is caused by bacteria:
- Pus on the tonsils
- Sore lymph glands in the neck
- NOT having a cough
- High temperature (fever)
In this case, antibiotic treatment may be necessary, so you should consider seeing a doctor.
- There are also special throat swabs that can be done on the spot by your doctor, to check for bacteria- these swabs can give a result within a few minutes.
- If symptoms are severe, unusual, or if they do not ease within a week, it is advisable see your doctor.
- Complications are pretty rare, but sometimes a sore throat can have a more serious cause, such as an abscess behind the tonsil (quinsy)- in this case the person is usually very ill and will find swallowing almost impossible.
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