What this protocol covers
The sore throat that reaches the counter: how to relieve it, when it suggests a bacterial cause and when it needs referring without delay.
1. What to ask
- How long has it been sore? Do they also have a cough, runny nose or hoarseness?
- Do they have a fever? Have they noticed painful lumps in the neck or white patches in the throat?
- Can they swallow their saliva and open their mouth properly?
- Do they take a medicine that can lower immunity (metamizole, carbimazole, chemotherapy, immunosuppressants)?
- How old are they? Are they pregnant?
2. Refer if any of these appear
- They cannot swallow even their saliva, are drooling, have a muffled voice or cannot open their mouth: it could be an abscess.
- Difficulty breathing: emergency department.
- High fever, white patches, painful glands in the neck and no cough: it could be a streptococcal throat infection, and the diagnosis is the doctor's.
- A sore throat with fever in someone taking metamizole, carbimazole or another medicine that can lower immunity: medical assessment the same day.
- More than 7 days without improving, or a skin rash.
3. If there are no red flags
Pain with cold symptoms (cough, runny nose)
- What relieves it most is an oral painkiller: paracetamol or ibuprofen at usual doses.
- Lozenges or sprays with a local anaesthetic (benzocaine, lidocaine) or an antiseptic, for short-term relief.
- Warm or cold drinks, sweets and not smoking.
If there are signs of a bacterial cause
- To the doctor: antibiotics are only supplied on prescription.
- Meanwhile, an oral painkiller for pain and fever.
4. Adjust to who will take it
- Pregnancy
- Paracetamol for the pain; NSAIDs are avoided from week 20. Before lozenges with an anaesthetic or antiseptic, check the product information or ask.
- Children
- Lozenges only at an age when there is no choking risk. Benzocaine never under 2 years (methaemoglobinaemia).
- Long-term conditions
- Weakened immunity, chemotherapy or a medicine that can cause agranulocytosis: any sore throat with fever is assessed by a doctor.
- Diabetes
- Sugar-free lozenges and sweets.
What not to recommend
- Antibiotics without a prescription, or ones left over from last time.
- Gargling with alcohol or vinegar: it irritates more.
- Several anaesthetic lozenges at once or above the leaflet dose.
What to say at the counter. What will relieve it most is a painkiller by mouth; lozenges help for a while. If you cannot swallow your saliva, find it hard to breathe or it is the same in a week, see the doctor.
Pharmacy Pills · conveniodefarmacia.com
Patient sheet: sore throat
To print and hand over. It carries only what the patient needs at home.
- Take the painkiller at the recommended dose; lozenges help for a while.
- Drink fluids and avoid smoking.
- Antibiotics only work if the cause is bacterial, and they are prescribed by a doctor.
- See the doctor if you cannot swallow your saliva, find it hard to breathe, cannot open your mouth or it has been the same for more than a week.
Self-assessment
Three questions. When you check your answers you will see the explanation for each one.
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Being unable to swallow saliva or having a muffled voice could be an abscess: it is assessed without delay.
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Fever and a sore throat on metamizole can be the first sign of agranulocytosis.
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An oral painkiller at usual doses gives the most relief; lozenges help for a while.
Training content. It does not replace the summary of product characteristics or clinical judgement.