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Sore Throat

Irritation of the throat

A sore throat is pain, scratchiness or irritation of the throat that often worsens when you swallow. The most common cause of a sore throat (pharyngitis) is a viral infection, such as a cold or the flu. A sore throat caused by a virus resolves on its own.

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Advice for Sore Throat

Strep throat (streptococcal infection), a less common type of sore throat caused by bacteria, requires treatment with antibiotics to prevent complications. Other less common causes of sore throat might require more complex treatment.

Tonsillitis is inflammation of the tonsils, two oval-shaped pads of tissue at the back of the throat — one tonsil on each side. Signs and symptoms of tonsillitis include swollen tonsils, sore throat, difficulty swallowing and tender lymph nodes on the sides of the neck.

Most cases of tonsillitis are caused by infection with a common virus, but bacterial infections also may cause tonsillitis. Because appropriate treatment for tonsillitis depends on the cause, it's important to get a prompt and accurate diagnosis. Surgery to remove tonsils, once a common procedure to treat tonsillitis, is usually performed only when tonsillitis occurs frequently, doesn't respond to other treatments or causes serious complications.

There are three types:

Acute tonsillitis - These symptoms usually last 3-4 days but can persist for up to 2 weeks.

Recurrent tonsillitis - This is when you get tonsillitis several times a year.

Chronic tonsillitis - This is when you have a long-term tonsil infection.

Risk factors

Although anyone can get a sore throat, some factors make you more susceptible, including:

Age - Children and teens are most likely to develop sore throats. Children ages 3 to 15 are also more likely to have strep throat, the most common bacterial infection associated with a sore throat.

Exposure to tobacco smoke - Smoking and secondhand smoke can irritate the throat. The use of tobacco products also increases the risk of cancers of the mouth, throat and voice box.

Allergies - Seasonal allergies or ongoing allergic reactions to dust, molds or pet dander make developing a sore throat more likely.

Exposure to chemical irritants - Particles in the air from burning fossil fuels and common household chemicals can cause throat irritation.

Chronic or frequent sinus infections - Drainage from your nose can irritate your throat or spread infection.

Close quarters - Viral and bacterial infections spread easily anywhere people gather, whether in child care centers, classrooms, offices or airplanes.

Weakened immunity - You're more susceptible to infections in general if your resistance is low. Common causes of lowered immunity include HIV, diabetes, treatment with steroids or chemotherapy drugs, stress, fatigue, and poor diet.

Inflammation or swelling of the tonsils from frequent or ongoing (chronic) tonsillitis can cause complications such as:

Disrupted breathing during sleep (obstructive sleep apnea)
Infection that spreads deep into surrounding tissue (tonsillar cellulitis)
Infection that results in a collection of pus behind a tonsil (peritonsillar abscess)

Tonsillitis most commonly affects children between preschool ages and the midteenage years. Common signs and symptoms of tonsillitis include:

Red, swollen tonsils
White or yellow coating or patches on the tonsils
Sore throat
Difficult or painful swallowing
Fever
Enlarged, tender glands (lymph nodes) in the neck
A scratchy, muffled or throaty voice
Bad breath
Stomachache
Neck pain or stiff neck
Headache

Viruses that cause the common cold and the flu also cause most sore throats. Less often, bacterial infections cause sore throats.

Viral infections

Viral illnesses that cause a sore throat include:

Common cold
Flu (influenza)
Mono (mononucleosis)
Measles
Chickenpox
Coronavirus disease 2019 (COVID-19)
Croup — a common childhood illness characterized by a harsh, barking cough

Bacterial infections

Many bacterial infections can cause a sore throat. The most common is Streptococcus pyogenes (group A streptococcus) which causes strep throat.

Other causes

Other causes of a sore throat include:

Allergies - Allergies to pet dander, molds, dust and pollen can cause a sore throat. The problem may be complicated by postnasal drip, which can irritate and inflame the throat.
Dryness - Dry indoor air can make your throat feel rough and scratchy. Breathing through your mouth — often because of chronic nasal congestion — also can cause a dry, sore throat.
Irritants - Outdoor air pollution and indoor pollution such as tobacco smoke or chemicals can cause a chronic sore throat. Chewing tobacco, drinking alcohol and eating spicy foods also can irritate your throat.
Muscle strain - You can strain muscles in your throat by yelling, talking loudly or talking for long periods without rest.
Gastroesophageal reflux disease (GORD) - GORD is a digestive system disorder in which stomach acids back up in the food pipe (esophagus).

Other signs or symptoms may include heartburn, hoarseness, regurgitation of stomach contents and the sensation of a lump in your throat.

HIV infection - A sore throat and other flu-like symptoms sometimes appear early after someone is infected with HIV. Also, someone who is HIV-positive might have a chronic or recurring sore throat due to a fungal infection called oral thrush or due to a viral infection called cytomegalovirus (CMV), which can be serious in people with compromised immune systems.

Tumors - Cancerous tumors of the throat, tongue or voice box (larynx) can cause a sore throat. Other signs or symptoms may include hoarseness, difficulty swallowing, noisy breathing, a lump in the neck, and blood in saliva or phlegm.

Rarely, an infected area of tissue (abscess) in the throat or swelling of the small cartilage "lid" that covers the windpipe (epiglottitis) can cause a sore throat. Both can block the airway, creating a medical emergency.

Most throat and tonsil infections are caused by viruses, although some are caused by bacteria. Viral infections cannot be treated with antibiotics. A swab can identify whether the infection is caused by a virus or a bacteria.

Even if a bacterial infection is the cause of tonsillitis, an antibiotic does not make much difference in most cases. The body's defences (immune system) usually clear these infections within a few days whether caused it is by a virus or a bacterium. Also, antibiotics can often cause side-effects such as diarrhoea, rash and stomach upsets.

The bacteria which tends to cause tonsillitis is a streptococcus. This is why sometimes people refer to tonsillitis as a "strep throat". At Pharmacinta, we provide either Penicillin V 250mg Tablets and Clarithromycin 250mg Tablets to treat tonsillitis.

There are two scoring systems which may be used to help decide how likely an episode is bacterial. These are called the FeverPAIN score and the Centor score. An antibiotic may be advised in certain situations. For example:

If the infection is severe.
If it is not easing after a few days.
If the immune system is not working properly (for example, if you have had your spleen removed, if you are taking chemotherapy, etc).

It can often feel as though antibiotics are needed because the tonsillitis settled quickly after getting antibiotics on a previous occasion - however, this is usually just because of the timeframe - people usually wait 2-3 days before seeking medical help and the vast majority of tonsillitis infections will settle within 3-5 days. For most people, fluids and painkillers are enough.

Home Care

Rest: Allow your body to recover by getting plenty of sleep.
Hydration: Drink fluids to stay hydrated and soothe the throat.
Warm Salt Gargles: Gargling with warm salt water can help reduce throat inflammation and pain.
Lozenges: Throat lozenges can provide temporary relief from soreness.
Humidifiers: Using a humidifier can add moisture to the air, helping ease throat discomfort.

Over-the-Counter Medications

Pain Relievers: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or acetaminophen can help reduce pain and fever.
Throat Sprays: Some sprays contain numbing agents to alleviate throat pain.

Medical Treatment

Antibiotics: If the tonsillitis is bacterial (e.g., strep throat), antibiotics are prescribed to eliminate the infection.
Corticosteroids: In severe cases, corticosteroids may be given to reduce inflammation and swelling.

Herbal Remedies

Chamomile Tea: Known for its anti-inflammatory properties, chamomile can help soothe the throat.
Honey: Has antibacterial properties and can coat the throat, providing relief from irritation.
Licorice Root: May help reduce throat inflammation; often consumed as tea.

Essential Oils

Tea Tree Oil: Has antibacterial properties; can be diluted and used in a steam inhalation.
Peppermint Oil: Can help relieve throat discomfort and may improve breathing; use in a diffuser or diluted in a carrier oil.

Homeopathy

Belladonna: Often used for sudden, intense symptoms of tonsillitis.
Mercurius: May help with swollen tonsils and throat pain.

Acupuncture

Some people find relief from throat pain and inflammation through acupuncture, which may help reduce overall inflammation.

Dietary Adjustments

Anti-inflammatory Foods: Incorporate foods rich in omega-3 fatty acids (like salmon), fruits, and vegetables to help reduce inflammation.
Avoid Irritants: Stay away from spicy, acidic, or crunchy foods that could irritate the throat further.

Hydration and Warm Compresses

Warm Compresses: Applying a warm compress to the throat can help reduce pain and swelling.
Hydration: Drinking warm broths or herbal teas can soothe the throat while keeping you hydrated.

Probiotics

Taking probiotics may support immune function and promote recovery, particularly after antibiotic use.

Tonsillectomy

Tonsils are an important part of your immune system, so your doctor will try to help you keep them. But if your tonsillitis keeps coming back or won’t go away, or if swollen tonsils make it hard for you to breathe or eat, you might need to have your tonsils taken out. This surgery is called tonsillectomy.

Tonsillectomy used to be a very common treatment. But now, doctors recommend this surgery only if your tonsillitis keeps coming back. That means you or your child has had tonsillitis more than seven times in one year, more than four or five times a year for the past 2 years, or more than three times a year for the past 3 years.

Frequently Asked Questions

Diagnosis usually involves a physical examination of the throat and may include a throat swab to test for bacterial infections like strep throat.

To reduce the risk: -Practice good hand hygiene. -Avoid close contact with infected individuals. -Stay up to date on vaccinations, including the flu vaccine.

Seek medical attention if symptoms are severe or persistent, especially if accompanied by high fever, difficulty breathing or swallowing, or if symptoms worsen despite home care.

Complications can include peritonsillar abscess (pus collection near the tonsils), rheumatic fever (following untreated strep throat), and persistent or recurrent infections.

Alternative treatments such as herbal remedies (e.g., chamomile tea, honey), essential oils (e.g., tea tree oil), and dietary adjustments (e.g., anti-inflammatory foods) may provide symptom relief, but should be used with caution and under medical guidance.

Maintaining proper hydration, avoiding irritants like smoking or exposure to pollutants, and practicing good overall health habits can support recovery and prevent recurrence.

Yes, tonsillitis caused by viral or bacterial infections can be contagious through close contact with infected individuals or exposure to respiratory droplets.

While tonsillitis is more common in children, adults can also develop tonsillitis, especially if exposed to infectious agents or if their immune system is compromised.

Tonsillitis refers to the inflammation of the tonsils, while strep throat specifically refers to a bacterial infection caused by Streptococcus pyogenes. Strep throat is a type of tonsillitis but not all tonsillitis cases are caused by strep bacteria.

In some cases, untreated bacterial tonsillitis (such as strep throat) can lead to complications like rheumatic fever or kidney inflammation (post-streptococcal glomerulonephritis), highlighting the importance of timely medical evaluation and treatment.

Yes, if you feel well enough. Tonsillitis makes some people feel more unwell than others. The majority of people can work whilst they have tonsillitis.

Bacterial tonsillitis does not usually cause a cough and it is one of the criteria that is used to decide how likely a bacterial infection is. Viral tonsillitis is often associated with symptoms like a cough and a cold.

Sore throats often feel worse at night. This may because the painkillers have worn off. It may also be that people sleep with their mouth open and, therefore, their mouth tends to be dry, which can add to the pain. Having water by the bed and taking painkillers just before going to bed can help.

Unfortunately there is nothing that will get rid of an infection more quickly. Drinking plenty of fluids and taking painkillers will help with the symptoms.

Clarithromycin works by binding to the bacterial ribosome, inhibiting protein synthesis. This action prevents the bacteria from growing and reproducing, leading to the elimination of the infection.

Yes, clarithromycin is effective in treating bacterial sinusitis, particularly when caused by bacteria that are sensitive to this antibiotic.

No, clarithromycin is a prescription medication and must be prescribed by a healthcare provider.

Clarithromycin is generally effective for respiratory infections caused by susceptible bacteria, including those causing bronchitis and pneumonia.

Yes, clarithromycin is part of combination therapy to treat Helicobacter pylori infections, which can cause stomach ulcers.

If you are pregnant or breastfeeding, discuss the potential risks and benefits with your doctor. Clarithromycin should be used during pregnancy or breastfeeding only if clearly needed and prescribed by a healthcare provider.

No, clarithromycin is an antibiotic and is not effective against viral infections such as the flu or the common cold.

If you suspect an overdose, seek immediate medical attention or call a poison control center. Symptoms of overdose may include severe nausea, vomiting, diarrhea, and abdominal pain.

Yes, clarithromycin can cause allergic reactions in some individuals. Symptoms may include rash, itching, swelling, severe dizziness, and difficulty breathing. Seek immediate medical attention if you experience these symptoms.

It is advisable to avoid alcohol while taking clarithromycin as it can increase the risk of liver damage and exacerbate side effects like dizziness and gastrointestinal discomfort.

If your symptoms do not improve or worsen after a few days of treatment, contact your healthcare provider for further evaluation and possible adjustment of your treatment plan.

Yes, penicillin, particularly amoxicillin, is often prescribed for bacterial sinusitis.

No, penicillin is a prescription medication and must be prescribed by a healthcare provider.

Penicillin is highly effective against many types of bacteria, particularly those causing respiratory tract infections, strep throat, and skin infections. Its effectiveness can vary based on bacterial resistance.

No, penicillin is ineffective against viral infections, such as the flu or the common cold. It only works against bacterial infections.

Penicillin is generally considered safe during pregnancy and breastfeeding. However, you should inform your healthcare provider if you are pregnant or breastfeeding before starting treatment.

Yes, penicillin can cause allergic reactions in some individuals. Symptoms may include rash, itching, swelling, severe dizziness, and difficulty breathing. Seek immediate medical attention if you experience these symptoms.