Most sore throats are caused by viruses, like ones that cause a cold or the flu, and do not need antibiotic treatment.
Some sore throats are caused by bacteria, such as group A Streptococcus (group A strep). Sore throats caused by these bacteria are known as strep throat. In children, 20 to 30 out of every 100 sore throats are strep throat. In adults, only 5 to 15 out of every 100 sore throats is strep throat.
When you have a sore throat, your tonsils often hurt and are usually red and swollen.
Other common causes of sore throats include:
- Dry air
- Pollution (airborne chemicals or irritants)
- Smoking or exposure to second-hand smoke
There are many things that can increase your risk for a sore throat, including:
- Age (children and teens between 5 and 15 years old are most likely to get a sore throat)
- Exposure to someone with a sore throat or strep throat
- Time of year (winter and early spring are common times for strep throat)
- Weather (cold air can irritate your throat)
- Irregularly shaped or large tonsils
- Pollution or smoke exposure
- A weak immune system or taking drugs that weaken the immune system
- Post-nasal drip or allergies
- Acid reflux disease
Signs and Symptoms
A sore throat can make it painful to swallow. A sore throat can also feel dry and scratchy, and may be a symptom of the common cold or other upper respiratory tract infection.
The following symptoms are often associated with sore throats caused by a viral infection or due to allergies:
- Watery eyes
- Mild headache or body aches
- Runny nose
- Low fever (less than 101 °F)
Symptoms more commonly associated with strep throat include:
- Red and swollen tonsils, sometimes with white patches or streaks of pus
- Tiny red spots (petechiae) on the soft or hard palate (the roof of the mouth)
- High fever (101 °F or above)
- Swollen lymph nodes in the neck
- Severe headache or body aches
When to seek medical care
See a healthcare professional if you have any of the following:
- Sore throat that lasts longer than 1 week
- Difficulty swallowing or breathing
- Excessive drooling (young children)
- Temperature higher than 100.4 °F
- Pus on the back of the throat
- Joint pain
- Hoarseness lasting longer than 2 weeks
- Blood in saliva or phlegm
- Dehydration (symptoms include a dry, sticky mouth; sleepiness or tiredness; thirst; decreased urination, few or no tears when crying; muscle weakness; headache; dizziness or lightheadedness)
- Recurring sore throats
Diagnosis and Treatment
Antibiotics are NOT needed to treat most sore throats, which usually improve on their own within 1–2 weeks. Antibiotics will not help if a sore throat is caused by a virus or irritation from the air. Antibiotic treatment in these cases may cause harm in both children and adults. Your healthcare professional may prescribe other medicine or give you tips to help with other symptoms like fever and coughing.
Antibiotics ARE needed if a healthcare professional diagnoses you with strep throat, which is caused by bacteria. This diagnosis can be done using a quick swab of the throat. Strep throat cannot be diagnosed by looking in the throat—a lab test must be done.
Antibiotics are prescribed for strep throat to prevent rheumatic fever. If diagnosed with strep throat, an infected patient should stay home from work, school, or day care until 24 hours after starting an antibiotic.
Regardless of the cause of the sore throat, there are many things you can do to help relieve the discomfort:
- Pain relieving medicines: acetaminophen (Tylenol) 500-1,000 mg every 6 hours (Maximum dose of 3,000 mg in 24 hours) and/or ibuprofen (Advil/Motrin) 600 mg with food every 6-8 hours as needed for pain relief. Be careful to avoid taking multi-symptom cold medicine that contains acetaminophen (Tylenol) with any other acetaminophen-may cause overdose.
- Drink more fluids (non-alcoholic), such as water, licorice root tea or hot tea with honey, broth, fruit juices, etc.
- Get extra rest.
- Salt water gargles (1/2 teaspoon salt dissolved in 8 oz. of warm water – gargle and spit it out – do not swallow).
- Sore throat lozenges (Cepastat, N’Ice, Sucrets, etc.) or hard candy dissolved in the mouth.
- Anesthetic sprays, such as Cepastat or Chloraseptic.
- Popsicles can help decrease a fever and increase fluids while soothing a sore throat.
- Decongestants, such as Pseudoephedrine 30-60 mg every four to six hours, if needed for nasal congestion.
- If you smoke, QUIT, or at least cut down. Smoking irritates the throat and prolongs symptoms. For help to quit smoking: call 812-855-7338 to meet with a Health & Wellness professional.
There are steps you can take to help prevent getting a sore throat, including:
- Practice good hand hygiene
- Avoid close contact with people who have sore throats, colds or other upper respiratory infections
- Avoid smoking and exposure to secondhand smoke