Sore throat

The regional formulary will not cover all eventualities for infections medicines choices. As with any condition; patient specific factors and sensitivities need to be considered. Please consider this regional formulary advice alongside any relevant local Board guidelines.

Treatment of acute sore throat

Analgesia, no antibiotic treatment. The majority of sore throats are viral and self-limiting. Do not prescribe an antibiotic for simple sore throats (majority resolve in 7 days) – only use antibiotics when there is evidence of bacterial infection.

Phenoxymethylpenicillin
Phenoxymethylpenicillin 250mg tablets

500mg every 6 hours for 5 days.

If penicillin allergic, prescribe clarithromycin.

Clarithromycin
Clarithromycin 500mg tablets

500mg every 12 hours for 5 days.

In pregnancy and penicillin allergic.

Erythromycin
Erythromycin 250mg gastro-resistant tablets

500mg every 6 hours for 5 days.

Prescribing Notes:

  • Serious streptococcal complications are rare and there is little evidence of benefit from prescribing antibiotics. If Modified Centor Criteria is 3 or 4 points, consider 2-3 day delayed or immediate antibiotics. Score 1 point for each of (lymphadenopathy, no cough, fever, tonsillar exudate). Age <15 years add 1 point, age >44 years subtract 1 point.
  • The FeverPAIN score for streptococcal pharyngitis may be helpful to consider.
  • Consider glandular fever if sore throat persists or patient is debilitated and not responding to antibiotics.

History Notes

30/07/2026

Regional formulary chapter launched.