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)
If several of those signs fit, or your symptoms are severe or lasting beyond a week, it’s worth a proper assessment: a doctor can evaluate you the same day, and prescribe antibiotics where they’re genuinely warranted: see sore throat treatment online.
- 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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Medically reviewed by Dr Aifric Boylan
MB · BCH · BAO · MICGP · FRACGP · DRCOG · DCH
About Dr Aifric Boylan MB BCh BAO MICGP FRACGP DRCOG DCH Fellow of the Royal Australian College of General Practitioners, Dr Aifric Boylan is a general practitioner with more than 20 years' experience. She graduated in medicine from…
This health information has been clinically reviewed by an Australian doctor. Qoctor health pages are reviewed to support clear, evidence-informed guidance; they do not replace individual medical advice.
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