A sore throat is one of the most common reasons people go looking for antibiotics, and one of the most common illnesses where antibiotics won't help. Most sore throats are caused by viruses, and they get better on their own.
That doesn't mean you have to just put up with it. There's a lot you can do to feel better while it runs its course, and there are clear signs that mean you should stop waiting and get seen. This guide covers both. It isn't a substitute for a clinician's assessment, and if you're worried, getting checked is always the right call.
Why antibiotics usually aren't the answer
Antibiotics treat bacteria. Viruses cause colds, flu, and most sore throats, and antibiotics don't work on viruses. The CDC lists most sore throats, other than strep throat, among the illnesses antibiotics won't help. (Our guide to antibiotics vs antivirals explains the difference in more detail.)
The NHS says sore throats are very common, are usually nothing to worry about, and normally get better by themselves within a week.
Viral sore throat vs strep throat
Some sore throats are bacterial. The main one is strep throat, caused by group A Streptococcus. It's treated with antibiotics, and the CDC says people who test positive typically get better faster with them.
Strep is less common than people often assume. The CDC puts it at about 1 in 10 adults and 3 in 10 children with a sore throat.
The CDC describes some signs that point more towards a virus, and some that are more typical of strep:
- More suggestive of a virus: a cough, runny nose, hoarse voice, or pink eye (conjunctivitis) along with the sore throat.
- More typical of strep: fever, pain when swallowing, red and swollen tonsils, sometimes with white patches or streaks of pus, and tiny red spots on the roof of the mouth.
You can't reliably tell them apart at home. A clinician can do a quick test. If you think it might be strep, especially in a child, get it checked rather than guessing.
Self-care that helps
The NHS recommends a handful of simple measures to ease a sore throat:
- Gargle with warm salty water. The NHS suggests dissolving half a teaspoon of salt in a glass of warm water. It notes this isn't suitable for children.
- Drink plenty of water. Staying hydrated helps, and a dry throat feels worse.
- Eat cool or soft foods. Anything that doesn't scrape.
- Avoid smoking and smoky places.
- Suck ice cubes, ice lollies or hard sweets. The NHS warns not to give young children anything small and hard to suck because of the choking risk.
- Rest.
The NHS also mentions pain relief that's available from a pharmacy, such as paracetamol or ibuprofen, and medicated lozenges or anaesthetic sprays. Use those according to the label, check whether they're suitable for you (some people shouldn't take ibuprofen, and some products aren't for children), and watch for doubled-up ingredients if you're also taking a cold and flu product. Our guide to common over-the-counter medication mistakes covers that. If you're not sure what's suitable, ask a pharmacist.
If you're taking an as-needed pain reliever, keep track of the time of each dose. The next dose time calculator shows the earliest time for your next dose from the interval on your label.
When to see a pharmacist
A pharmacist is a good first stop for a sore throat. The NHS notes that a pharmacist can give the same antibiotic treatment as a GP for a sore throat if you need it, for people aged 5 and over. They can also advise on remedies and tell you whether you should be seen by a doctor.
When to see a GP or doctor
The NHS advises seeing a GP if:
- A child under 5 has a sore throat.
- The sore throat lasts more than a week.
- You keep getting sore throats.
- You have a lump in your neck or mouth, or a mouth ulcer, that has lasted three weeks or more.
It also advises getting urgent advice (in the UK, NHS 111 or an urgent GP appointment) if you have a very high temperature or feel hot, cold or shivery, if you have signs of dehydration, if you have a weakened immune system, or if you're worried about your symptoms.
Red flags: get emergency help
The NHS says to call 999 or go to A&E (in the US, call 911 or go to an emergency department) if someone with a sore throat:
- Has difficulty breathing or swallowing.
- Is drooling, which can be a sign they can't swallow.
- Makes a high-pitched sound when breathing.
- Has symptoms that are getting severe very quickly.
Don't wait to see if these improve.
If you are prescribed antibiotics
If a clinician does diagnose strep throat or another bacterial infection and prescribes antibiotics, take them exactly as prescribed, for as long as you were told. Don't save leftovers or share them. The CDC's advice on antibiotic use is clear on all three.
A course with a fixed interval and a set end date is easy to lose track of when you feel unwell. Doz can hold the prescription with how long the course runs, and it supports Critical Alerts, so a reminder can come through even when your iPhone is on Silent or a Focus is on. Our post on choosing an antibiotic reminder app covers the setup.
Frequently Asked Questions
Can a sore throat go away without antibiotics?
Usually, yes. Most sore throats are caused by viruses, which antibiotics don't treat. The NHS says they normally get better by themselves within a week. Self-care such as warm salty water gargles, fluids, soft foods and rest can ease symptoms in the meantime.
How do I know if my sore throat is strep?
You can't tell for certain at home. The CDC says strep often causes fever, painful swallowing, and red, swollen tonsils sometimes with white patches, while a cough, runny nose or hoarse voice suggests a virus. A clinician can do a quick test. About 1 in 10 adults and 3 in 10 children with a sore throat have strep, according to the CDC.
When should I worry about a sore throat?
Get emergency help for difficulty breathing or swallowing, drooling, a high-pitched sound when breathing, or symptoms getting severe quickly. See a GP if it lasts more than a week, keeps coming back, or a child under 5 has one. Get urgent advice for a very high temperature, signs of dehydration or a weakened immune system.
What is the fastest way to soothe a sore throat?
The NHS suggests gargling with warm salty water (not for children), drinking plenty of water, eating cool or soft foods, and sucking ice cubes or hard sweets (not for young children). Pharmacy pain relief, lozenges or sprays can also help. Ask a pharmacist which is suitable for you.
Can a pharmacist help with a sore throat?
Yes. A pharmacist can recommend remedies, tell you if you should see a doctor, and in England can provide antibiotics for a sore throat for people aged 5 and over who need them, according to the NHS.
Where to start
If your sore throat started in the last few days and you have none of the red flags, start with the self-care list above and give it a week. Note when it started, so you'll know if it's lasting longer than it should. If you're unsure at any point, ask a pharmacist, and if any of the emergency signs appear, get help straight away.
Sources
Download Doz on the App Store · Read the FAQ · More from the blog