When to refer
When to refer
Get your pharmacist involved if a customer reports any of the following:
- A high temperature (above 38°C) that does not respond to medication, such as paracetamol
- Severe pain
- Breathing problems
- Difficulty swallowing (this means dehydration is a possibility
- A muffled voice
- A high-pitched noise when breathing (this is known as stridor)
- Drooling
- A sore throat that has not improved after a week.
Certain patient groups should also always be referred because they are more at risk of complications. These include:
- Anyone with HIV, AIDS, leukaemia or aplastic anaemia
- Anyone with diabetes
- Individuals with a spleen that has been removed or does not work properly
- Any patient on chemotherapy, immunosuppressants (most commonly because of an organ transplant) or a medicine that can cause blood disorders (e.g. neutropenia or agranulocytosis).
Important note
Antibiotics are sometimes hailed as the solution for a sore throat, but given that the vast majority of sore throats are caused by viral infections, antibiotics are frequently ineffective. They do, however, have a place in the management of people who are at increased risk of developing a severe infection, such as those on immunosuppressant medication, or who suffer recurrent infections that are believed to be caused by Streptococcus bacteria.
In some situations, a “delayed prescription” may be provided, whereby the person is advised to wait a few days and only have the antibiotics dispensed if their symptoms worsen or do not improve.
This approach has been shown to reduce unnecessary antibiotic use – and thus help to prevent antibiotic resistance.