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Intended for Healthcare Professionals
British Journal of General Practice

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Clinical Practice

Use of antibiotics for acute sore throat and tonsillitis in primary care

Christopher R Wilcox, Michael Moore and Paul Little
British Journal of General Practice 2022; 72 (716): 136-137. DOI: https://doi.org/10.3399/bjgp22X718793
Christopher R Wilcox
Primary Care Research Centre, University of Southampton, Southampton, UK.
Roles: Academic clinical fellow in general practice
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Michael Moore
Primary Care Research Centre, University of Southampton, Southampton, UK.
Roles: Professor of primary care research
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Paul Little
Primary Care Research Centre, University of Southampton, Southampton, UK.
Roles: Professor of primary care research
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Antibiotics are commonly prescribed for sore throat in primary care, yet are often of limited benefit.1 They are commonly associated with adverse effects, and contribute towards healthcare costs and antibiotic resistance at both the global and individual level.1 Prescribing antibiotics also reinforces patients’ belief in the need for antibiotics, and increases the chance of re-attendance in the future.2

With a view to helping clinicians optimise antibiotic use, this article summarises evidence concerning the aetiology and natural history of sore throat, incidence of complications, and the use of clinical prediction tools, and compares the outcomes of different antibiotic prescription strategies (no, immediate, and delayed antibiotics), as well as patients’ views on these approaches.

ANTIBIOTICS AND THE NATURAL COURSE OF ILLNESS IN SORE THROAT

Around two-thirds of cases are viral (higher in children), and the remainder are usually caused by group A beta-haemolytic streptococci (particularly Streptococcus pyogenes), and, less commonly, group C and G streptococci.1,3 Sore throat is also a feature in approximately 50% of mild-to-moderate COVID-19 disease.4

The latest Cochrane review found that, among patients not prescribed antibiotics, 40% were symptom free by day 3 of illness, and 80% were symptom free by 1 week.1 This was similar in Streptococcus-positive, -negative, and untested participants. On average, antibiotics reduced the duration of symptoms by 16 hours.1

COMPLICATION RATES

Concern about complications is often a …

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British Journal of General Practice: 72 (716)
British Journal of General Practice
Vol. 72, Issue 716
March 2022
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Use of antibiotics for acute sore throat and tonsillitis in primary care
Christopher R Wilcox, Michael Moore, Paul Little
British Journal of General Practice 2022; 72 (716): 136-137. DOI: 10.3399/bjgp22X718793

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Use of antibiotics for acute sore throat and tonsillitis in primary care
Christopher R Wilcox, Michael Moore, Paul Little
British Journal of General Practice 2022; 72 (716): 136-137. DOI: 10.3399/bjgp22X718793
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  • Top
  • Article
    • ANTIBIOTICS AND THE NATURAL COURSE OF ILLNESS IN SORE THROAT
    • COMPLICATION RATES
    • CLINICAL PREDICTION TOOLS
    • ARE PURULENT TONSILS AN IMMEDIATE INDICATION FOR ANTIBIOTICS?
    • DELAYED VERSUS IMMEDIATE ANTIBIOTICS FOR SORE THROAT
    • PATIENT EXPECTATIONS
    • DELAYED PRESCRIPTIONS IN PRACTICE
    • SELF-MANAGEMENT STRATEGIES
    • BOTTOM LINE
    • Notes
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More in this TOC Section

  • Cardiac implantable electronic devices: an overview for primary care
  • Recognising and diagnosing Cushing’s syndrome in primary care: challenging but not impossible
  • Safeguarding alerts on electronic medical records
Show more Clinical Practice

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Print ISSN: 0960-1643
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