What is a sore throat?

A sore throat is the very common result of an infection by any one of a large number of bacteria or viruses. It is part of a collection of illnesses ranging from the common cold to glandular fever. The sore throat may be accompanied by sniffles, cough and feeling generally weak and feverish.

What happens?

Bacteria and viruses infect the tissues at the back and sides of the throat. The body then mounts its immune response to the infection, and this can cause the glands ("lymph nodes") in the neck to swell and become tender.

Most people (90%) are over the infection within one week. Half of us are feeling better in half that time - about three days.

How is it treated?

Give your body a hand to heal itself by:

• resting as much as you can - take time off work and do not send your child to school or pre-school
• drinking plenty of clear fluid - don't worry if you or your child does not feel like eating much for a couple of days. Children and adults may find ice-blocks refreshing
• gargling at least twice a day with a glass of warm water with a teaspoon of salt dissolved in it (older children and adults only)
• taking medicines to control the pain and fever
• vitamin C tablets (which you can purchase directly from the pharmacy) may also be slightly effective.

What about antibiotics?

Most people do not need antibiotics for a sore throats - in many cases they are caused by viruses (which are not controlled by antibiotics) or unidentified bacteria.

Antibiotics also do not make much difference to the symptoms - in fact they only shorten the average illness by about eight hours! Another way of looking at it is this - you have a 50% chance of being better in three days without antibiotics, and within three days with them. In either case - with or without antibiotics - you have a 90% chance of being better in seven days.

Although it is not considered worthwhile to routinely prescribe antibiotics for most children, Maori or Pacific Island children or those coming from crowded home circumstances may benefit from taking antibiotics. This is because the chances of them developing other health problems such as ear infections, rheumatic fever or glomerulonephritis are higher than for most children.

Recent studies have shown that for every 35 children treated with antibiotics for sore throats, only one ear infection would be prevented.

Pain relief

Pain relief should be considered. Pain relief will allow you to eat and drink more comfortably and it has the added benefit of reducing fever if it is a problem. Paracetamol, paracetamol combined with codeine, or with codeine and aspirin are useful and safe if used in the correct doses.

Paracetamol and ibuprofen, a nonsteroidal anti-inflammatory drug, are also safe and effective in children. (NB. Do not give aspirin-containing medications to children under 15 years of age.)

In adults, ibuprofen or aspirin may be taken. Adults with peptic or duodenal ulcers, bleeding conditions or who are taking anti-coagulant medicine should not take these drugs.

Go or return to the doctor if

• you or your child has not recovered after seven days
• you have or your child complains of ear pain
• you have or your child complains of neck stiffness - rather than throat just pain
• you or your child cannot swallow water or saliva (spit)
• you have other medical problems which affect how your body can heal itself, eg, diabetes or immune disorders.

For further information and support talk to your family doctor, practice nurse or pharmacist.

Written by Anna Mickell RCpN. Reviewed by everybody.