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.

sore throat
  • 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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