Recent NICE guidelines, published on 26 January 2018, give details on Sore throat (acute): antimicrobial prescribing and there is a summary of the findings provided below.

You can read the full guidelines here.

The guidelines set out an antimicrobial prescribing strategy for acute sore throat. It aims to limit antibiotic use and reduce antimicrobial resistance. Acute sore throat is often caused by a virus, lasts for about a week, and most people get better without antibiotics. Withholding antibiotics rarely leads to complications.1

Self-limiting, acute sore throats (including pharyngitis and tonsillitis), are often triggered by a viral infection of the upper respiratory tract. Symptoms can last for about a week, but most people will get better without antibiotics, regardless of whether it is caused by bacteria or a virus.1

Next steps

Prescribe an over-the-counter treatment, such as Difflam Throat Spray or Difflam Sore Throat Rinse, to manage the symptoms of acute sore throat, including pain, soreness, swelling and discomfort.

Concerned patients should be advised of evidence that antibiotics make little difference to how long symptoms last, and that most people feel better after 1 week, with or without antibiotics.1

When a back-up antibiotic prescription is given, advice should be given about an antibiotic not being needed immediately, so the prescription can be used if symptoms do not start to improve within 3-5 days or if they worsen rapidly at any time.1

Patients should seek medical help if their symptoms worsen rapidly or significantly, do not start to improve after 1 week, or they become systemically very unwell.1

  • NICE guideline [NG84] ‘Sore throat (acute): antimicrobial prescribing.’ Issued January 2018.
    Available at

This site is designed for UK healthcare professionals only. If you are not a UK healthcare professional please contact your GP or continue