Acute Sore Throat

NHSL Antimicrobial Guidelines
NHS Lanarkshire

Advise paracetamol, or if preferred and suitable, ibuprofen for pain.

Use FeverPAIN or Centor to assess symptoms:

FeverPAIN 0-1 or Centor 0-2: no antibiotic

FeverPAIN 2-3: no or back-up antibiotic

FeverPAIN 4-5 or Centor 3-4: immediate or back-up antibiotic

Systemically very unwell or high risk of complications: immediate antibiotic

 

Return if symptoms significantly worsen or don’t resolve after antibiotic is stopped

When giving a delayed antibiotic prescription, advise:

  • Antibiotic is not needed immediately
  • Use if symptoms rapidly deteriorate, significantly worsen, or do not improve within 3 to 5 days
  • Manage symptoms with self-care

Drug details

Drug

First choice:

Phenoxymethylpenicillin

Dosage

500mg

Duration

4 times a day or 1G twice daily for 5 or 10 days depending on severity of symptoms*

child dose

*5 days of phenoxymethylpenicillin may be enough for symptomatic cure; Use a 10-day course if proven or probable Group A Streptococcus.

Drug

Penicillin allergy: Clarithromycin

Dosage

250-500mg

Duration

twice daily 5 days

child dose

Drug

OR (penicillin allergy in pregnancy)

Erythromycin

Dosage

250-500mg

or 500-1000mg

Duration

4 times a day

twice daily 5 days

Editorial Information

Last reviewed: 18/05/2022

Next review date: 18/05/2025

Author(s): NHS Lanarkshire Antimicrobial Management Committee, Dr Dundas, Dr Hylands, S McCormick, Heather Boyle.

Version: V1

Approved By: AMC; ADTC

Reviewer name(s): NHS Lanarkshire Antimicrobial Management Committee.

Document Id: June 2022