Sore Throat

What is it?

Sore throat (pharyngitis) is one of the most frequent reasons for antibiotic prescriptions, yet approximately 85–95% of cases in adults are caused by viruses for which antibiotics provide no benefit. Group A Streptococcus (strep throat) accounts for 5–15% of adult pharyngitis and does require antibiotic treatment to prevent complications (rheumatic fever, peritonsillar abscess). The Centor criteria (tonsillar exudate, tender anterior lymph nodes, absence of cough, fever) help identify who needs a rapid strep test. Infectious mononucleosis (EBV) should be considered in adolescents and young adults with severe pharyngitis.

Common causes

When to see a doctor

• 1Difficulty swallowing or drooling (possible peritonsillar abscess or epiglottitis)
• 2Muffled voice, hot potato voice, or trismus (jaw spasm)
• 3Sore throat with fever above 38.5°C and white patches on tonsils (test for strep)
• 4Severe sore throat with a rash (possible scarlet fever)
• 5Throat pain lasting more than a week without improvement
• 6Difficulty breathing or throat swelling in a child

What you can do

• ✓Gargle warm salt water (1/4–1/2 tsp salt in 8 oz water) several times daily
• ✓Stay hydrated with warm liquids: tea with honey, warm broth, or warm water
• ✓Use a humidifier to keep air moist and prevent further throat dryness
• ✓OTC lozenges with benzocaine or menthol provide temporary numbing relief
• ✓Get adequate rest — most viral sore throats resolve in 5–7 days
• ✓Do not demand antibiotics for a viral throat — they will not help and contribute to antibiotic resistance

Conditions that cause this symptom

Medications that may help

Treatment depends on the underlying cause. Always consult your provider before starting any medication.

Frequently asked questions