Sore Throat
Also known as Pharyngitis
This article is general health information for the selected condition. It is not a diagnosis and does not replace clinical judgement. If you have questions or need treatment advice, please consult a qualified healthcare professional.
What is sore throat?
Sore throat is usually caused by a virus and settles within a week without treatment. A minority are bacterial, most often group A Streptococcus, where antibiotics shorten illness slightly and reduce rare complications. The clinical task is distinguishing the two, since most sore throats do not need antibiotics.
Causes
- Viral infection including cold and flu viruses
- Group A Streptococcus bacteria
- Glandular fever, particularly in teenagers
- Acid reflux irritating the throat
- Allergies and postnasal drip
- Smoke and dry air irritation
Symptoms
- Pain on swallowing
- Red or swollen tonsils
- Swollen tender neck glands
- Hoarse voice
- Cough and runny nose in viral causes
- White patches on the tonsils in some infections
- Fever
Risk factors
- Age 5 to 15 for streptococcal infection
- Close contact in schools and households
- Smoking or smoke exposure
- Allergies
- Weakened immune system
Diagnosis
- Clinical assessment using FeverPAIN or Centor scoring
- Rapid antigen test for group A Streptococcus
- Throat swab where testing is unavailable or uncertain
- Monospot testing if glandular fever is suspected
- Assessment for abscess if symptoms are one sided and severe
Treatment
- Paracetamol or ibuprofen for pain
- Adequate fluids and rest
- Medicated lozenges or anaesthetic sprays for short term relief
- Antibiotics only when bacterial infection is likely
- Avoiding amoxicillin where glandular fever is possible
- Urgent drainage if a peritonsillar abscess develops
Self care
- Drink plenty of cool or warm fluids, whichever soothes more
- Gargle warm salt water several times a day
- Suck lozenges or ice for numbing relief
- Take regular paracetamol or ibuprofen rather than waiting for severe pain
- Avoid smoking and smoky environments
- Use a humidifier if the air is dry
- Eat soft foods if swallowing is painful
When to see a doctor
Book an appointment if:
- Sore throat lasting more than a week
- Recurrent sore throats several times a year
- Difficulty swallowing fluids
- A hoarse voice lasting more than three weeks
- Sore throat with a widespread rash
- Weakened immune system or on medicines affecting white cells
Some symptoms need emergency care rather than an appointment. See the warning signs listed above.
Prevention
- Wash hands regularly
- Avoid sharing cups and utensils
- Stay away from people with streptococcal infection until treated
- Stop smoking
- Treat reflux and allergies that irritate the throat
Outlook
Most sore throats resolve within a week regardless of cause. Streptococcal infection improves within a day or two of antibiotics, which are given mainly to prevent rare complications such as rheumatic fever and abscess. Recurrent severe episodes may warrant discussion of tonsillectomy, though this is reserved for frequent well documented cases.
Common questions
How do I know if I need antibiotics?
Cough and a runny nose point strongly to a virus and away from antibiotics. Fever, swollen tender glands, pus on the tonsils and the absence of cough raise the likelihood of streptococcal infection, which a rapid test can confirm.
What is quinsy?
A collection of pus beside the tonsil causing severe one sided pain, difficulty opening the mouth, drooling and a muffled voice. It needs urgent assessment and drainage rather than antibiotics alone.
References
Important: Dard AI is not a medical device and does not diagnose, treat, or replace clinician judgement. This article is general information only. Always consult a qualified healthcare professional about diagnosis and treatment, and seek emergency care for severe or rapidly worsening symptoms.