A sore throat is generally a self-limiting condition. It is not possible to distinguish between the appearances of a viral or bacterial infection, although it is thought that at least 70% of sore throats are caused by viruses and are therefore not suitable for treatment with antibiotics.
Patients should see their GP if the tonsils are very red or swollen and there are white spots of pus. The pus spots could be a sign of streptococcal infection, which could respond to antibiotic therapy.
Duration and frequency
Sore throats caused by either viral or bacterial infections will usually disappear spontaneously within a few days, and as such they are not serious. A sore throat persisting for more than 1 week requires medical attention. Recurrent infections could be due to complications such as uncontrolled diabetes or medication, and therefore should be seen to by a GP.
Lozenges and spray
Probably the most useful effect of lozenges lies in their ability to stimulate the flow of saliva, which acts as a demulcent and soothes the throat. Some lozenges contain anti-inflammatory agents which also have analgesic properties. These are more effective that normal lozenges although their use is limited to 3 days and is not suitable for children under the age of 12 years, patients already taking non-steroidal anti-inflammatory drugs (NSAIDs) or those with a history of asthma, and those with a known allergy to aspirin or NSAIDs.
For patients who can take aspirin, another approach to the treatment of a sore throat is to dissolve one or two soluble aspirins and use the solution as a gargle. The effect is essentially similar to using NSAID lozenges.
- Analgesics such as paracetamol will also alleviate the pain.
- Keeping the throat hydrated with fluids will also alleviate the soreness.
When to see your GP
- Accompanied by skin rash.
- History of rheumatic fever or artificial heart valves.
- Long-term or recurrent hoarseness or loss of voice.
- Earache that does not resolve after 48 hours or is accompanied by a discharge.
- Difficulty in swallowing.
- Recurrent tonsillitis in children.