Sore throats: Do antibiotics help?

Antibiotics can shorten the symptoms of sore throats caused by infections by less than a day. There are adverse effects, though, so that weighing up the pros and cons is an individual exercise.

Sore throats usually get better by themselves without treatment. After about three days, 34 out of every 100 people (34%) already feel a lot better. After a week, even without treatment, about 82 out of every 100 people (82%) no longer have a sore throat. Even when a person also has a fever, the sore throat has usually started to go away after three days without treatment.

With such a high rate of spontaneous recovery, whether or not antibiotics can help here is a real question. To try to find out, researchers from the Cochrane Collaboration (an international network of researchers) studied 27 trials in which more than 12,800 people with sore throats 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 Cochrane researchers did a new search in 2008 but they did not find further good-quality trials in this area.

The trials showed that taking antibiotics only helped a bit. Out of 100 people who took antibiotics, 51 were over their sore throats on the third day (51%). In comparison, 34 out of 100 people who did not take antibiotics were also over their symptoms by the third day (34%). On average, sore throats were shortened by less than a day. After a week there was no longer much difference between the two groups: 87 out of 100 people with antibiotics were free of sore throats, 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. These are fairly uncommon, though, in healthy people.

The limited benefit of antibiotics in the treatment of common sore throats needs to be considered in light of their adverse effects. Other studies have estimated that about 10 out of every 100 people (10%) will experience adverse effects from antibiotics. Also, bacteria can become resistant (unresponsive) to antibiotics if these drugs are overused. This means that a lot of medical 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: German Institute for Quality and Efficiency in Health Care (IQWiG)

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