Sore throat

Sore throat encompasses pharyngitis, tonsillitis, and laryngitis.

The diagnosis is clinical: throat swabs and rapid antigen tests should not be carried out routinely in patients with a sore throat

Management

• paracetamol or ibuprofen for pain relief
• antibiotics are not routinely indicated
• there is some evidence that a single dose of oral corticosteroid may reduce the severity and duration of pain, although this has not yet been incorporated into UK guidelines

NICE indications for antibiotics

• features of marked systemic upset secondary to the acute sore throat
• unilateral peritonsillitis
• a history of rheumatic fever
• an increased risk from acute infection (such as a child with diabetes mellitus or immunodeficiency)
• patients with acute sore throat/acute pharyngitis/acute tonsillitis when 3 or more Centor criteria are present

Scoring systems

The Centor criteria are: score 1 point for each (maximum score of 4)

• presence of tonsillar exudate
• tender anterior cervical lymphadenopathy or lymphadenitis
• history of fever
• absence of cough