Sore throat and tonsillitis

Overview

Sore throat is among the commonest presentations in general practice, and its management is a masterclass in restraint: antibiotics confer a modest symptom benefit measured in hours, against a background of complete natural resolution within a week for almost everyone.^[1] The consultation's real work is triage — separating the overwhelming viral majority from the streptococcal minority that benefits from antibiotics, the glandular fever pattern that must not receive amoxicillin, and the rare presentations (quinsy, epiglottitis) that must leave the surgery by ambulance.

References5ShowHide

1. [1]Spinks A et al. Antibiotics for treatment of sore throat in children and adults. Cochrane Database Syst Rev, 2021.PMID 34881426
2. [2]Little P et al. Clinical score and rapid antigen detection test to guide antibiotic use for sore throats: randomised controlled trial of PRISM (primary care streptococcal management). BMJ, 2013.PMID 24114306
3. [3]Paradise JL et al. Tonsillectomy and adenotonsillectomy for recurrent throat infection in moderately affected children. Pediatrics, 2002.PMID 12093941
4. [4]Chovel-Sella A et al. Incidence of rash after amoxicillin treatment in children with infectious mononucleosis. Pediatrics, 2013.PMID 23589810
5. [5]Stelter K Tonsillitis and sore throat in children. GMS Curr Top Otorhinolaryngol Head Neck Surg, 2014.PMID 25587367