Most sore throats are viral and settle in about a week without an antibiotic. A scoring system decides who benefits, and antibiotics shorten symptoms by about 16 hours on average. A same day telephone consultation is £59 and an in person appointment is £150.
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Any of these needs to be seen the same day. If you are severely unwell, go to your nearest emergency department or call 999.
A sore throat is inflammation of the throat or tonsils. Most are caused by viruses and a minority by bacteria, and the two cannot be reliably told apart by looking, which is the source of most unnecessary prescribing.NICE NG84, 2018
It settles on its own in around a week in most people, with or without treatment. The purpose of an assessment is to identify the small group who benefit from an antibiotic and the smaller group who are seriously unwell.Cochrane Database of Systematic Reviews Spinks, 2021
Fever, pus on the tonsils, tender neck glands and the absence of a cough are the four features that raise the probability of a bacterial cause, and scoring systems built on them are what decide who is offered treatment.The BMJ Little, 2013
A sore throat lasting more than 3 weeks, particularly alongside a persistent neck lump, hoarseness or unexplained weight loss, is investigated rather than treated. That threshold is a referral pathway rather than a judgement call.NICE NG12, 2015
Send us what you are seeing and we will tell you what it is likely to be.
The assessment scores the features, checks how unwell you are overall, looks for the signs of a complication, and asks about your medicines, because some affect the immune system and change the threshold entirely.NICE NG84, 2018
A throat swab is not routine. A test that identifies the organism does not change the decision in most people, because the decision is driven by how unwell you are and by the score rather than by what grows.NICE NG84, 2018
Where a cough dominates and the chest is the concern, that is assessed as a different problem, with a different threshold for treatment.NICE NG120, 2019
Pain relief and time
The right answer for most sore throats. Regular paracetamol or ibuprofen, fluids, and about a week. That is not a soft option, it is what the evidence supports for a low score.NICE NG84, 2018
A medicated lozenge or spray
Reduces pain modestly for a few hours. It is symptom relief rather than treatment and it is bought rather than prescribed.NICE NG84, 2018
A back up prescription
The prescription issued but held, used only if things have not improved after a few days. It reduces antibiotic use substantially without leaving anyone stranded over a weekend. When to use it and when not to is agreed with you before you leave.General Medical Council GMC guidance, 2020
An immediate antibiotic
For a high score, for someone systemically unwell, or where the risk of complication is raised. Antibiotics shorten symptoms by around 16 hours on average across everyone treated, which is the honest size of the benefit.Cochrane Database of Systematic Reviews Spinks, 2021
Same day assessment in person
Where swallowing is difficult, the voice is muffled, or one side is much worse than the other. Those are the presentations that need looking at rather than describing.NICE NG84, 2018
Most sore throats improve within a week. Where an antibiotic is taken, symptoms improve faster by about 16 hours on average, which is why the decision is not automatic and why a back up prescription is often the better middle.Cochrane Database of Systematic Reviews Spinks, 2021
The inconvenient half. Antibiotics also cause side effects, and treating everyone with a sore throat to shorten symptoms by less than a day is the mechanism by which resistance builds. Taking one when you do not need it costs you and everybody else.NICE NG84, 2018
Score yourself on the four features before you call. Fever in the last 24 hours, pus on the tonsils, tender glands in the neck, and no cough. Four out of four makes a bacterial cause much more likely. None of them makes it unlikely, and either answer saves the appointment time.The BMJ Little, 2013
Take regular pain relief properly rather than occasionally. Paracetamol or ibuprofen at the full dose on the packet, at regular intervals for 48 hours, does more for a sore throat than any lozenge. Most people take too little too late.NICE NG84, 2018
Learn the three signs that are not a sore throat. Difficulty breathing, drooling because you cannot swallow, and a muffled voice with severe one sided pain. Any of those goes to your nearest emergency department or 999 rather than to a booking page.NICE NG84, 2018
Do not buy an antibiotic online for a sore throat you have not had assessed. It shortens symptoms by less than a day on average, it carries side effects, and most sore throats are viral and gain nothing from it.Cochrane Database of Systematic Reviews Spinks, 2021
Do not pay for a throat swab. It does not change the decision in most people, because that decision is driven by the score and by how unwell you are rather than by what grows on a plate 2 days later.NICE NG84, 2018
Step 1
15 minutes by telephone. The four features scored, how unwell you are overall, and your medicines checked.
Step 2
An immediate prescription for a high score, a back up prescription to use only if it has not turned, or pain relief and a week, which is the right answer for most.
Step 3
Difficulty swallowing, a muffled voice, one sided pain or 3 weeks of symptoms all get looking at rather than describing.
Ask before you book if you are not sure this is the right appointment.
Usually not. Most are viral and settle within a week. Antibiotics shorten symptoms by around 16 hours on average across everyone treated, so they are offered where a scoring system suggests a bacterial cause or where you are systemically unwell.
About a week for most people, with the worst 2 or 3 days at the start. Anything lasting more than 3 weeks, particularly with a neck lump, hoarseness or weight loss, is investigated rather than treated as an ordinary sore throat.
Difficulty breathing, drooling because you cannot swallow your own saliva, or a muffled voice with severe one sided pain and difficulty opening your mouth. Any of those needs 999 or your nearest emergency department the same hour.
A prescription issued at the consultation but held rather than used, taken only if things have not improved after a few days. It cuts antibiotic use substantially and it means nobody is stuck without an option over a weekend.
Not usually. A swab identifies what grows and does not change the decision, which is driven by the score and by how unwell you are. The result also takes about 2 days, by which point most sore throats are improving anyway.
A same day telephone consultation is £59. An in person appointment is £150 for 30 minutes and a same day urgent slot is £220. A blood panel, where the throat is part of a longer illness, is £350. Any prescription is dispensed and priced by the pharmacy.
Regular paracetamol or ibuprofen at the full dose on the packet, taken at proper intervals for 48 hours rather than occasionally. That does more than any lozenge or spray, and most people under treat it and then judge it as not working.
This page is general information about a condition and it is not a diagnosis. Treatment depends on what a doctor finds when they examine you, and no outcome is guaranteed. If you are severely unwell, or if any of the warnings at the top of this page apply to you, go to your nearest emergency department or call 999.
Cochrane Database of Systematic Reviews
Antibiotics for sore throatSpinks, 2021
General Medical Council
Decision making and consentGMC guidance, 2020
NICE
NICE
NICE
Cough (acute), antimicrobial prescribingNG120, 2019
The BMJ
Clinical score and rapid antigen detection test to guide antibiotic use for sore throats, the PRISM studyLittle, 2013
Written by the clinical team at The Wellness. Awaiting clinical sign off.
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