Duration Health

Throat

Introduction

Most of the time, a sore throat is caused by allergies or viral infection. In these cases, you may also have associated nasal congestion or runny nose or bilateral ear pain. However, when the pain lasts more than a few days, is severe or associated with high fever, difficulty swallowing or difficulty breathing, or causes swelling of one side of the throat, it may be due to a bacterial infection.

Treatment

For mild to moderate throat pain without fever, consider ibuprofen. If you have an associated high fever or if the throat pain lasts over 3 days and is severe, you may have a bacterial infection and can take amoxicillin (or amoxicillin-clavulanate if regular amoxicillin is unavailable).

Most sore throats are NOT strep throat and do NOT need antibiotics. Millions of people suffer side effects every year, including uncontrollable diarrhea, after taking antibiotics for a sore throat when one is not necessary. Before considering antibiotics, is highly recommended to try ibuprofen first and wait to see if your symptoms resolve, especially if you do not have a fever.

When To Worry

Seek immediate medical care if you have any of the following:

Quick Guide

If you have

  • mild sore throat
  • nasal congestion
  • cough
  • no fever

You may have

viral upper respiratory infection

Consider using

ibuprofen 600 mg every 6 hours as needed for pain OR

acetaminophen 1000 mg every 6-8 hours as needed for pain (do not exceed 3000 mg per day)

If you have

  • fever
  • white pus in your throat
  • NO cough
  • NO nasal congestion
  • tender lymph nodes ("swollen glands") in neck

You may have

strep throat

Consider using

amoxicillin-clavulanate 875 mg-125mg twice daily for 10 days

Note: if amoxicillin is available, consider using amoxicillin instead of amoxicillin-clavulanate

Note: if amoxicillin is unavailable or if an allergy to penicillins is present, azithromycin may be considered as an alternative, although it may be less effective.

If you have

  • severe sore throat
  • visible swelling on one side of the throat
  • fever
  • muffled voice
  • difficulty swallowing
  • difficulty breathing
  • drooling/pooling saliva

You may have

peritonsillar abscess or retropharyngeal abscess

You should

seek emergency medical care

Reference

Ibuprofen (generic for Motrin, generic for Advil) is a pain reliever and the most commonly used non-steroidal anti-inflammatory drug (NSAID). Ibuprofen is used to treat pain.

GeneralMedication

Acetaminophen (generic for Tylenol) is a pain reliever and fever reducer. Acetaminophen is used to treat pain.

GeneralMedication

Amoxicillin-clavulanate (generic for Augmentin) is an antibiotic. It can be used to treat skin infections like bite wounds, ear infections, sinus infections, tooth infections, and other infections. This medication should be taken with food.

InfectionMedication

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