Healthcare professionals should tell their patients that most sore throats do not need antibiotics, the National Institute for Health and Care Excellence (NICE) and Public Health England have said. 

The announcement follows research that found of all GP appointments made in the UK for respiratory tract infections, just over 1 in 4 (27%) were for sore throats.

The evidence reviewed by NICE

The evidence reviewed by NICE found most sore throats are triggered by a viral infection. Most people will get better without antibiotics, usually experiencing symptoms for up to a week. However, research suggests antibiotics are prescribed in 60% of cases.

NICE says healthcare professionals should help people to manage their symptoms with pain relief, such as paracetamol or ibuprofen.

Some adults may wish to try medicated lozenges containing either a local anaesthetic, a non-steroidal anti-inflammatory drug (NSAID) or an antiseptic. However, they should be told these may only help to reduce pain by a small amount.

Dr Tessa Lewis, GP and chair of the managing common infections guidance committee, said: “A sore throat can be very painful, making you feel tired and unwell for about a week. But in most cases antibiotics will not make much difference. Instead, we should drink plenty of fluids and rest.

“Paracetamol can help to relieve pain and control temperature. Medicated lozenges might not reduce the pain by much, but some people may choose to use them.”

Professor Cliodna McNulty, Head of Primary Care Unit, Public Health England said: “Antibiotics are a precious resource and it’s important that they are only used when they are really needed. For a sore throat, evidence shows that antibiotics make little difference to length or severity of illness, unless symptoms are much more severe. While a sore throat can be painful, there are other ways to control the symptoms including taking paracetamol and medicated lozenges.”

The guidance says people who have a sore throat caused by streptococcal bacteria are more likely to benefit from antibiotics. It highlights two scoring tools, FeverPAIN* and Centor** as useful ways for prescribers to identify these patients.

Professor Gillian Leng, deputy chief executive at NICE, said: “The evidence shows antibiotics are not an effective treatment for the majority of sore throats. People who need them should be given them, and our advice will support those decisions. But it is clear that routine prescribing in all cases isn’t appropriate.

“We are living in a world where bacteria are becoming resistant to antibiotics. It is vital these medicines are protected, and only used when they are effective.”