Sore throat- when is an antibiotic needed?

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When do you need an antibiotic 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.

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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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