SORE THROAT

Incidence peaks at 5-10 and 15-25 years. Spectrum includes laryngitis, pharyngitis and, in a few, tonsillitis; clinical distinction between the last two not always clear. Streptococcal tonsillitis more likely if patient is less than 11 years old, with myalgia, fever history, tonsillar exudates, tender or swollen cervical lymph glands, less likely if cough/earache present. If recurrent sore throat very troublesome, e.g. child often misses school, tonsillectomy may be indicated but is not undertaken lightly.

Acute sore throat (including pharyngitis and tonsillitis) is self-limiting and often triggered by a viral infection of the upper respiratory tract. Symptoms can last for around 1 week, but most people will get better within this time without antibiotics, regardless of cause (bacteria or virus). 

Assess and manage children under 5 who present with fever in line with the NICE guideline on fever in under 5s (NG143). 

Use FeverPAIN or Centor criteria to identify people who are more likely to benefit from antibiotics.