Treatment options: Analgesia or antibiotics?

Most sore throats are self-limiting and 90 per cent of patients feel better or improve within one week of the onset of symptoms, whatever the cause and with or without antibiotics.

The National Institute for Health and Care Excellence (NICE) states that “antibiotics make little difference to how long symptoms last or the number of people whose symptoms improve”. Trust in pharmacists to make antibiotic decisions has increased in recent years and stood at 71 per cent in a Public Health England 2020 study of over 2,000 adults.

The same research found that about one-third of participants incorrectly believed that antibiotics effectively treat viral or fungal infections, showing that patient education remains crucial. The authors concluded that health care professionals need to explain the rationale for withholding antibiotics, especially to lower educational attainment and black, Asian and minority ethnic (BAME) patients, who were more likely to challenge the denial of antibiotics.1

The pharmacy team can offer treatment to provide some relief from discomfort and pain until the infection subsides. Oral analgesics are first-line and recommended for all patients, even those given antibiotics.
A systematic review of clinical trials found that simple analgesics (paracetamol, aspirin and ibuprofen) are very effective at reducing the pain from sore throat. Some medicated lozenges and pastilles have a soothing effect. NICE states that “medicated lozenges containing benzocaine, hexylresorcinol or flurbiprofen may help to reduce pain in adults”. There is also some limited evidence that benzydamine spray is effective in relieving sore throat pain.