Sore throat: causes, treatment, when to act

What causes a sore throat?

NICE says acute sore throat is often caused by a viral infection, and most people get better without an antibiotic. A University Hospitals Sussex NHS leaflet lists tonsillitis, laryngitis, strep throat and glandular fever as other common causes of a sore throat. NICE suggests scoring tools (FeverPAIN or Centor) to spot people with a sore throat who may be more likely to benefit from an antibiotic, and these include fever, pus on the tonsils, tender neck glands and no cough.

How long does it last, and what helps?

A sore throat usually clears up on its own and often lasts about a week. NHS 111 Wales says a pharmacist can advise about paracetamol or ibuprofen for the pain, and a hospital trust leaflet notes that not everyone can take ibuprofen safely.

Are antibiotics needed?

NICE says most people with a sore throat will not need an antibiotic. NICE says a scoring tool (FeverPAIN or Centor) should be used to identify people with a sore throat who may be more likely to benefit from an antibiotic.

What are tonsillitis, glandular fever and quinsy?

A GP can often diagnose tonsillitis from the symptoms and a look at the throat, a swab can show whether bacteria are the cause, and a blood test for glandular fever is recommended if symptoms are severe or will not go away. The NHS says glandular fever is most common in people aged 15 to 24. Antibiotics do not work for glandular fever because it is caused by a virus. Quinsy is a collection of pus between the tonsil and the wall of the throat, and is a complication of tonsillitis.

When should a GP be seen?

The NHS says to contact a GP practice if a sore throat has not started to improve after a week, and to ask for an urgent GP appointment or call NHS 111 for a very high temperature, feeling hot, cold or shivery, or a weakened immune system. A sore throat that does not get better within 10 to 14 days, or that gets worse rather than better, may suggest glandular fever.

When is a sore throat an emergency?

The NHS says to call 999 or go to A&E for difficulty breathing, being unable to swallow, or drooling. Other reasons are a high-pitched noise when breathing in, a sore throat that is severe and getting worse quickly, swelling inside the mouth or throat, or trouble speaking. NHS 111 Wales advises that a person should not drive themselves to A&E but should ask someone to drive them or call 999.