Treatment options
Treatment options: Analgesia or antibiotics?
Most sore throats are self-limiting and 90 per cent of patients feel better or improve within one week of the onset of symptoms, whatever the cause and with or without antibiotics.
The National Institute for Health and Care Excellence (NICE) states that “antibiotics make little difference to how long symptoms last or the number of people whose symptoms improve”. Trust in pharmacists to make antibiotic decisions has increased in recent years and stood at 71 per cent in a Public Health England 2020 study of over 2,000 adults.
The same research found that about one-third of participants incorrectly believed that antibiotics effectively treat viral or fungal infections, showing that patient education remains crucial. The authors concluded that health care professionals need to explain the rationale for withholding antibiotics, especially to lower educational attainment and black, Asian and minority ethnic (BAME) patients, who were more likely to challenge the denial of antibiotics.1
The pharmacy team can offer treatment to provide some relief from discomfort and pain until the infection subsides. Oral analgesics are first-line and recommended for all patients, even those given antibiotics.
A systematic review of clinical trials found that simple analgesics (paracetamol, aspirin and ibuprofen) are very effective at reducing the pain from sore throat. Some medicated lozenges and pastilles have a soothing effect. NICE states that “medicated lozenges containing benzocaine, hexylresorcinol or flurbiprofen may help to reduce pain in adults”. There is also some limited evidence that benzydamine spray is effective in relieving sore throat pain.
Managing pain and discomfort
Managing pain and discomfort
Self care advice aims to prevent dehydration where there is fever, and to manage the discomfort associated with drinking and eating:
- Advise regular use of paracetamol or ibuprofen to relieve pain and fever – a raised temperature should settle in 36-48 hours
- Encourage adequate fluid intake to avoid dehydration if fever is present
- Provide advice regarding food and drink to avoid exacerbating pain (e.g. avoid hot drinks and stick to warm or cold fluids)
- Adults or older children may find sucking throat lozenges, hard boiled sweets, ice, or flavoured frozen desserts (such as ice lollies) provide additional symptomatic relief
- Gargling with warm salty water at frequent intervals can help soothe the throat until the discomfort and swelling subside (not advised for children)
- Not smoking and staying away from smoky environments will prevent further irritation of the throat.