Overview
Sore throat is usually caused by viral pharyngitis, which settles in 5-7 days without antibiotics. Around one in five cases in adults is bacterial, most often group A streptococcus.
Doctors use scoring systems such as FeverPAIN and Centor - fever, pus on the tonsils, absence of cough and tender neck glands - to estimate the likelihood of a bacterial cause and decide whether antibiotics will help.
When to seek urgent medical help
- • Difficulty breathing, drooling or inability to swallow fluids - emergency
- • Severe one-sided pain with muffled voice or trouble opening the mouth (possible quinsy)
- • Symptoms lasting over a week with high fever or a widespread rash
Symptoms and signs
- Painful throat, worse on swallowing
- Swollen tonsils with white patches or pus
- Fever, chills and general aching
- Tender, swollen glands in the neck
- Absence of cough and runny nose (more suggestive of bacterial infection)
- Bad breath, hoarse voice or earache on swallowing
Management and treatment
Pain relief with regular paracetamol or ibuprofen, fluids and medicated lozenges is effective for viral sore throat. Antibiotics are reserved for cases with a high probability of bacterial infection or for those at higher risk of complications.
Your ChatDoc doctor applies the same clinical scoring used in general practice, rules out red flags and prescribes antibiotics only when they are genuinely indicated.
Prescription treatment options
Phenoxymethylpenicillin (penicillin V)
First-line 10-day antibiotic course for confirmed bacterial tonsillitis.
Clarithromycin or erythromycin
Alternative antibiotic for penicillin allergy.
Analgesia and anaesthetic throat sprays
Regular paracetamol or ibuprofen plus benzydamine to control pain and allow eating.
Short corticosteroid course
Occasionally used for severe pain and swelling in adults alongside other treatment.
Any prescription is issued only after a doctor has reviewed your case and considers the treatment safe and appropriate for you.
Your online Sore Throat & Tonsillitis assessment
- 1
Tell us about your concern
Share symptoms, past treatments, medicines and relevant health information.
- 2
Upload clear photos
Upload photos of your concern where applicable.
- 3
Doctor reviews your case
Technology helps organise your answers, but every assessment and prescription decision is made by a doctor, who may message you if they need more information.
- 4
Get your personalised plan
A personalised prescription is issued if treatment is clinically appropriate.
Prognosis and outlook
Viral sore throat settles within a week. Bacterial tonsillitis improves within 48-72 hours of starting antibiotics, though the full course should always be completed.
Recurrent tonsillitis (seven or more episodes in a year) warrants an ENT opinion about tonsillectomy.
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This page is general medical information and does not replace a personal consultation. Always seek urgent care for severe or rapidly worsening symptoms. ChatDoc is not an emergency service. Call 999 (UK) or 112 (EU) for life-threatening emergencies or 111 for urgent non-emergency help. Do not wait for an online reply.