Sore Throat Treatment

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Sore Throat

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Before you start a diagnosis, please read all of the information below.

A sore throat is a very common condition and is usually caused by an infection in the throat. In 82% of cases, the symptoms will settle within 7 days without antibiotics. Many infections are mild, will get better quickly and do not need any specific treatment. Unnecessary use of antibiotics may cause side effects and may increase the incidence of antibiotic resistance. You can speak to your pharmacist for further advice on over-the-counter treatments available to help you manage your sore throat.

Types of throat infections include acute pharyngitis and acute tonsillitis. Acute pharyngitis is an infection of the throat and is most commonly caused by viruses, however, some can be caused by bacteria. Acute tonsillitis is inflammation of the tonsils usually caused by a viral or bacterial infection. The tonsils are glandular tissue at the back of the throat and are part of the immune system. 

Symptoms of a throat infection tend to worsen over 2-3 days and then gradually settle, usually within a week. The infection spreads through coughing, sneezing or breathing droplets which are infected with the germs. If these viruses or bacteria are breathed in by someone else, then it may be passed on. The infection can also be spread through contact. This includes direct contact with another person or through indirect contact such as touching surfaces contaminated with the germs. 

If your throat infection is worsening or not improving, then you may want to 'Start a Diagnosis' with i-GP or see your own GP. 

Please see Common Treatments below for further information.


Common Symptoms

The commonest symptom of a throat infection is a sore throat. Other symptoms may include:

  • difficulty in swallowing
  • fever
  • cough
  • headache
  • swollen glands
  • earache
  • tiredness
Common Treatments

Most throat infections are viral, do not require antibiotics, and will improve within a week on their own. Common treatments for the symptoms include paracetamol, ibuprofen, and throat lozenges which can help with the pains and fever. You can seek further advice about such over the counter treatments from your local pharmacy.

Possible treatments we prescribe if clinically appropriate:

*Prices shown are cost price of the medication, taken from the British National Formulary 2018, and are given as a guideline. Pharmacies will add a dispensing fee to this which will vary considerably, so it is worthwhile phoning around to compare prices. The medication is paid for at your chosen pharmacy. 

Please click on the medication above to read the Patient Information Leaflet for important information about each drug. We use national prescribing guidelines to select which treatment would be most appropriate for your condition. 

Self-help for the symptoms

There are certain treatments that you can try at home which may help you to manage your symptoms.

Pain medication 

  • such as paracetamol or ibuprofen. Read the leaflet that comes with the medication to check its suitability. This can help with the pain and fever.

Over-the-counter gargles, lozenges, and sprays 

  • may help to soothe a sore throat but they do not shorten the illness.

Drinking plenty of water to keep hydrated

  • drink lots of cool or warm fluids, and avoid very hot drinks
  • suck on ice cubes or ice lollies 

Gargling with salt water

  • mix half a teaspoon of salt with 250ml of warm water and gargle. However, do not to swallow the water.
Treating your infection without antibiotics

Information about Phenoxymethylpenicillin

Phenoxymethylpenicillin is sometimes prescribed for throat infections.

Do not take Phenoxymethylpenicillin if you are allergic to penicillin.

Before you start the treatment always read the manufacturers leaflet contained with the medication, which contains more information and the potential side effects.

The dose is to be taken four times a day, it is important that you space out the doses evenly during the day. Swallow the tablet with water, and you should take phenoxymethylpenicillin on an empty stomach. Take your dose one hour before you eat any food, or wait until two hours afterwards. This is because your body absorbs less of the medicine after a meal, which means it is less effective.

Possible side effects to Phenoxymethylpenicillin

Most types of medicines can cause potential side effects. However, not everyone will experience them. The side effects often improve as your body adjusts to the new medicine, but if any of them continue or become troublesome then contact us, or speak with your doctor or pharmacist. 

The most common ones for phenoxymethylpenicillin (occur in about 1 in 10 people) include:

  • Feeling sick (nausea) or vomiting
  • Diarrhoea
  • Redness and itching in the mouth or vagina (thrush)
  • Skin rashes

If you develop a skin rash then it is important you speak to a doctor as soon as possible. 

Information about Clarithromycin

Clarithromycin is sometimes prescribed for a throat infection, it is used if you have an allergy to penicillins.

Always read the manufacturers leaflet contained with the medication. This contains more information and lists all the potential side effects.

The dose is to be taken twice a day. It is important that you space out the doses evenly during the day. Swallow the tablet with water and you can take it either before or after food.

Keep taking Clarithromycin until the full course is finished (unless a doctor tells you to stop), even if you feel that the infection has cleared up. This is to stop the infection from coming back. If you forget to take a dose, take one as soon as you remember unless it's nearly time for your next dose. In this case, just leave out the missed dose and take your next dose as normal.

Possible side effects to Clarithromycin

Most types of medicines can cause potential side effects. However, not everyone will experience them. The side effects often improve as your body adjusts to the new medicine, but if any of them continue or become troublesome then contact us, or speak with your doctor or pharmacist. 

The most common ones (occur in about 1 in 10 people) for Clarithromycin include:

  • feeling sick (nausea) or vomiting
  • diarrhoea
  • redness and itching in the mouth or genital area (thrush)
  • tooth or tongue discolouration, and changes in the way things taste or smell. This will settle once you finish treatment
  • a headache
Who should not take Clarithromycin

It is important that you tell your doctor in your assessment of all the medical conditions you have, and all the medications you take. Failure to do so can lead to problems with any treatment you are prescribed. Always read the patient leaflet before you take any medication. 

The following groups of people should not take Clarithromycin:

  • those allergic to clarithromycin or macrolide antibiotics
  • those with QT prolongation or ventricular cardiac arrhythmia, including torsades de pointe
  • those with heart disease
  • those with hypokalaemia (low potassium)
  • those with problems with the way your liver works
  • pregnant women or if breastfeeding 

The following medications can interact with Clarithromycin:

  • Statin for lowering cholesterol: you should stop your statin while you are taking Clarithromycin.
  • Colchicine used for gout: clarithromycin should not be taken if you are also taking colchicine. 
  • Warfarin: Clarithromycin can increase the bleeding risk
  • Ergotamine or dihydroergotamine used for migraines: Clarithromycin must not be taken with them
  • Sildenafil, tadalafil or vardenafil: Clarithromycin can increase the levels of the erectile dysfunction (ED) medication in the body. Consider reducing the dose of the ED medication while taking Clarithromycin. 
When to seek further medical advice

If after trying over-the-counter treatments, your symptoms worsen, you develop swollen tonsils with pus or your symptoms do not ease within a week, then you should seek further medical advice. You may wish to 'Start a Diagnosis' with i-GP or see your own GP. 

How to find NHS services near you

In an emergency call 999 for immediate help for life-threatening conditions.

During working hours you can contact your GP surgery for help or call NHS 111. Alternatively, the following links can help you find Urgent Care Centres or Out of Hours care near you:


England 

Website: NHS Choices or telephone NHS 111


Wales

Website: NHS Direct Wales or telephone NHS Direct Wales on 0845 46 47 or the new 111 Wales Service for Swansea Neath Bridgend & Carmarthen


Scotland

Website: NHS Inform  or call NHS 111


Northern Ireland

Website: Health and Social Care

The contact telephone numbers for out of hours GP services in your area can be found here: NI Direct Government Services

Symptoms unsuitable for i-GP

There are certain symptoms that may be present with a sore throat that suggests you should see a doctor in person, as soon as possible. You will require a physical assessment and you may require further investigations.

  • severe pain
  • a persistent high temperature (fever) which does not settle
  • a severe illness, especially when symptoms are mainly on one side of the throat

If you develop any of the symptoms below, then you must seek urgent medical advice immediately (from your GP, Out of Hours Service, Urgent care centre, NHS 111). Call an ambulance or go to A&E if the symptoms are severe.

  • difficulty swallowing saliva or opening your mouth.
  • difficulty in breathing
  • stridor (noisy breathing)
  • chest pain
  • a severe headache
  • drowsiness or confusion
  • persistent vomiting
  • neck stiffness
  • a non-blanching rash 

Allergic reaction to medications

An itchy rash, swollen face or mouth, or difficulty in breathing, may be signs that you are allergic to the medication. 

Please note that i-GP DOES NOT TREAT Medical Emergencies. 

If you develop a sudden onset of any of the symptoms below then you must STOP the medication immediately and seek urgent medical advice. This could be from your GP, Out of Hours Service, Urgent Care Centre or NHS 111. Call an ambulance or go to A&E if the symptoms are severe.

  • Wheeze
  • Difficulty in Breathing
  • Swelling of the eyelids, face or lips
  • A rash particularly if affecting your entire body
Antibiotic Resistance

Antibiotics should be used responsibly and only when really necessary. Overuse and misuse of antibiotics can lead to antibiotic resistance. This is where the antibiotic becomes less effective at treating certain types of bacterial infection, so they do not work when needed. 

Antibiotics should be taken as prescribed, and it is important to complete the full course, this can reduce the chance of the bacteria developing an immunity to that antibiotic. It is important not to share antibiotics, and always take unused medication to your local pharmacy for disposal.

References

NICE CKS Acute Sore throat July 2015

Patient.info; Sore Throat 

Respiratory tract infections (self-limiting): prescribing antibiotics; NICE Clinical Guideline (July 2008)

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