Acute Sore Throat

Acute sore throat
CKS
FeverPAIN

Avoid antibiotics as 82% resolve in 7 days without, and pain only reduced by 16 hours. Use FeverPAIN Score: Fever in last 24h, Purulence, Attend rapidly under 3d, severely Inflamed tonsils, No cough or coryza).  Score 0-1: 13-18% streptococci, use NO antibiotic strategy; 2-3: 34-40% streptococci, use 3 day back-up antibiotic; >4: 62-65% streptococci, use immediate antibiotic if severe,  or 48hr short back-up prescription.                                       

Always share self-care advice & safety net.

Antibiotics to prevent Quinsy NNT >4000.

Antibiotics to prevent Otitis media NNT 200.

10d penicillin lower relapse vs 5d in <18yrs.

Phenoxymethylpenicillin

500mg QDS or 1G BD (QDS when severe)

 child dose

5-10 days

Penicillin Allergy: clarithromycin

250-500mg BD 

child dose

5 days

Penicillin Allergy in Pregnancy: Erythromycin

500mg QDS

5 days