Sore throats are one of the most frequent complaints of students visiting the Student Health Center. It is important to understand what causes them, how to treat them, and why antibiotics are usually NOT recommended for sore throats.
Causes of Sore Throats
Sore throats are usually caused by infection with either a virus or bacteria, (though sometimes they are caused by other things like acid reflux or allergies). In adults, the majority of sore throats are caused by viruses. They are often accompanied by other symptoms like cough, fever, and congestion. A small percentage of sore throats in adults are caused by infection with a bacteria. The main bacteria we worry about is Group A Strep (aka "Strep Throat"). Strep Throat causes only about 10 % of sore throats in adults. Strep throat is much more common in kids than in adults, so healthcare providers may treat sore throats in children differently than those in adults.
Treatment of Sore Throats
Most sore throats can be effectively treated with rest, salt-water gargles, plus over-the-counter medicines like pain relievers (acetaminophen or ibuprofen), lozenges, throat sprays and/or teas. Drinking plenty of warm or cold beverages helps to ease discomfort and prevent dehydration. It's important to avoid spreading the infection to others, so wash hands frequently and avoid close contact or sharing eating or drinking utensils with others. Most sore throats will go away on their own, without any specific treatment. This can take a few days to a few weeks. Antibiotics are usually not helpful for sore throats, so we don't usually recommend them.
Antibiotics never work on viruses, and should not be used to treat viral infections. Antibiotics do work on bacteria, but for many bacteria that infect the throat, they haven't been shown to make much difference.
Strep Throat is an exception. Strep Throat infections can be serious, and can (rarely) cause other serious problems with the heart or kidneys if not treated. For this reason we treat Strep Throat with antibiotics.
Diagnosing the Cause of a Sore Throat
Except for Group A Strep (Strep Throat), it usually isn't necessary to identify which exact virus or bacteria is causing your sore throat, since most will resolve on their own. However, if we suspect you may have Strep Throat, we will recommend testing for it. Diagnosing Strep Throat requires a lab test. A Rapid Strep test is available in the SHC (for a small fee) that takes about 10 minutes for results. A negative Strep test means no antibiotics are needed. If we do not recommend a Strep test, it means that, based on your symptoms and physical exam, the likelihood that you have Strep Throat is very low. You can request the Strep test even if we don't recommend it. A throat culture is another test that we may use to diagnose the cause of your sore throat. Throat cultures can identify Group A Strep, as well as other bacteria that infect the throat. Throat cultures take 3-5 days for results. Mononucleosis ("mono") is a virus that can cause severe sore throat. It is diagnosed with a blood test. A Mono test may be recommended in some cases. Mono is not treated with antibiotics.
When Should You See a Healthcare Provider for Your Sore Throat?
The majority of sore throats can be managed at home with the treatments listed above. You should see a healthcare provider if:
- You have significant pain or swelling, and/or are having trouble swallowing, despite the over-the- counter treatments above
- You are having trouble staying hydrated
- You have a high fever (over 102), or any fever over 100 that lasts more than 5 days
- You have a known exposure to Strep Throat within the past 10 days, and you have sore throat symptoms
- You have a health condition, or take medications, that suppress your immune system
- Your sore throat is worsening after 3-5 days, or is persisting for more than 2 weeks