Sore throat: Do antibiotics make it go away faster?

Taking antibiotics as a precaution can shorten the symptoms of sore throats by between half a day and one day. There is a risk of side effects, though. And using antibiotics too often can make bacteria resistant.

Sore throats are a common reason to go to the doctor – particularly in the colds season. Then you might have to decide whether you will take an antibiotic or not. Most people do not have an advantage from taking antibiotics: Sore throats caused by infections are usually caused by viruses, which antibiotics have no effect on. People with a bacterial infection of the throat, however, are more likely to have a benefit. In practice it is hard to tell whether or not the infection is being caused by bacteria. And taking antibiotics “just in case” can have disadvantages.

Research shows: Sore throats usually get better by themselves without treatment. After about three days, 34 out of every 100 people already feel a lot better. After a week, even without treatment, about 82 out of every 100 people no longer have a sore throat. Even when a person also has a fever, this too has usually mostly gone away after three days without treatment.

Benefit of antibiotic therapy

With such a high rate of spontaneous recovery, it is a real question how big the benefit of drugs like antibiotics is in sore throats. Doctors behave very differently: Some are prepared to write a prescription for antibiotics just in case. Others only prescribe antibiotics if there are concrete signs of a bacterial infection. To find out what benefit antibiotics have when they are taken as a precaution, researchers from the Cochrane Collaboration, an international network of researchers, analyzed 27 of these trials, in which more than 12,800 people took part. The people in these trials were divided into different groups. In each trial, one group took antibiotics and another took a fake medicine (placebo). You can read about why it is important to carry out research in this way to ensure that the results are reliable here.

The trials show that taking antibiotics can speed up recovery a little bit:

• Out of 100 people who took antibiotics, 51 had no symptoms on the third day.
• In comparison, 34 out of 100 people who did not take antibiotics were over their inflammation by the third day.

On average, sore throats can be shortened by about 16 hours, which is less than one day.

After a week there was no longer much difference between the two groups: 87 out of 100 people with antibiotics were free of symptoms, and so were 82 out of 100 people who did not take antibiotics.

One other impact of antibiotics was that they lowered the rate of complications, including middle ear infections. But these are also fairly uncommon in otherwise healthy people who do not receive any treatment.

The limited benefit of antibiotics in the treatment of sore throats needs to be considered in the light of their adverse effects. Other trials allow the conclusion that about 10 out of every 100 people will experience side effects from antibiotics. The most common side effects include diarrhea and skin rash. Also, germs can become unresponsive (resistant) to antibiotics if these drugs are overused in treating mild diseases. This means that a lot of serious conditions can no longer be treated as successfully as they used to be. You can find out more about the correct use of antibiotics here.

You can read more about colds, their prevention and treatment here.

Author: Institute for Quality and Efficiency in Health Care (IQWiG)


Next planned update: February 2015. You can find out more about how our health information is updated here.

© IQWiG (Institute for Quality and Efficiency in Health Care)