Sore Throat

Antibiotics can shorten 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%) are already getting 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 is usually starting to go away in 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 studied 27 trials in which more than 12,800 people with sore throats took part.

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 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 (87%), and so were 82% of the people who did not take antibiotics.

One other impact of antibiotics was that they lowered the rate of complications, including for example middle ear infections and the rare complication, rheumatic fever. These are fairly uncommon, though, in healthy people.

The limited benefit from antibiotics for common sore throats needs to be considered in the light of their adverse effects. Other studies have estimated that about 10 out of every 100 people (10%) will experience adverse effects from antibiotics, especially diarrhoea.

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