Sore throat | Mate korokoro

Also called pharyngitis

Sore throats (mate korokoro) can be painful and cause discomfort when you swallow.

COVID-19 pandemic
If you have any respiratory symptoms such as a cough, sore throat, shortness of breath, head cold or loss of smell, with or without fever, call your GP or Healthline's dedicated COVID-19 number 0800 358 5453 to check whether you need to be tested for COVID-19.

On this page, you can find the following information:

What causes a sore throat?
What are the symptoms of a sore throat?
When to see your doctor about a sore throat
How are the causes of a sore throat diagnosed?
How is a sore throat treated?
What can I do to ease a sore throat?

Key points about sore throats

Having a sore throat is very common, especially in children (see sore throat in children). The discomfort can range from a scratchy feeling to severe pain.
A sore throat can be caused by a viral infection such as a cold or the flu or a bacterial infection, most commonly Streptococcus (often known as 'strep throat').
If you are at higher risk of rheumatic fever, you need to have any sore throat checked by a nurse or GP. This is because untreated strep throat can cause rheumatic fever and heart damage for life.
If you are at higher risk of rheumatic fever and you have strep throat you will be prescribed a course of antibiotics.
If you are not at higher risk of rheumatic fever, antibiotics are usually not required or helpful for a sore throat.

Seek immediate medical help if you:
have difficulty breathing, eg, struggling for each breath or making a grunting noise with each breath have great difficulty swallowing develop a skin rash are not able to drink much or shows signs of dehydration (very dry mouth, no urine for more than 8 hours, confused and drowsy) develop a fever (high temperature) have severe pain at the back of your throat have any other symptoms that appear life threatening. Call Healthline 0800 611 116 if you are unsure what to do.

Seek immediate medical help if you:

have difficulty breathing, eg, struggling for each breath or making a grunting noise with each breath
have great difficulty swallowing
develop a skin rash
are not able to drink much or shows signs of dehydration (very dry mouth, no urine for more than 8 hours, confused and drowsy)
develop a fever (high temperature)
have severe pain at the back of your throat
have any other symptoms that appear life threatening.

Call Healthline 0800 611 116 if you are unsure what to do.

Māori and Pasifika children are most at risk of developing rheumatic fever and should see a doctor or nurse if they show ANY sign of sore throat.

What causes a sore throat?

Around 90% of sore throats are caused by viral infections such as the common cold or flu. Viral sore throats usually get better by themselves within a week. Antibiotics do not fix viral sore throats.

Some sore throats are caused by bacteria, most commonly Streptococcus (often known as 'strep throat'). Children and young people at risk of rheumatic fever require treatment with antibiotics for 10 days to prevent rheumatic fever. Read more about strep throat.

Other conditions that can cause a sore throat include:

What are the symptoms of a sore throat?

The main symptoms of a sore throat are:

a painful or scratchy throat, especially when you swallow
difficulty swallowing
redness at the back of your mouth
bad breath
cold and flu symptoms such as a cough, hoarseness, red eyes and runny nose (usually not seen with strep throat).
the glands in your neck are swollen
your tonsils are large and covered in white stuff.

It is not possible to be sure from symptoms whether a sore throat is caused by a virus or bacteria. This is why people at higher risk of rheumatic fever should always get a throat swab done. See diagnosis and treatment of strep throat.

When to see your doctor about a sore throat

People at higher risk of rheumatic fever

For people at higher risk of rheumatic fever, it is very important that a sore throat is always checked early by a nurse or GP. This is because untreated strep throat can cause rheumatic fever and heart damage for life.

You are at higher risk of rheumatic fever if:

you have had rheumatic fever before
someone in your family or household has had rheumatic fever.

Or if you have 2 or more of the following:

Māori or Pasifika ethnicity
Aged 3–35 years
Live in poorer or crowded living conditions.

Everyone else

If you are not high risk for rheumatic fever, you should see your GP or nurse if your symptoms are not improving after 48 hours, or if you:

have neck stiffness or ear pain
have swollen glands (feel for tender lumps in your neck) that are getting bigger
have any other symptoms you are concerned about.

Seek immediate medical help if you:
have difficulty breathing, eg, struggling for each breath or making a grunting noise with each breath have great difficulty swallowing develop a skin rash are not able to drink much or shows signs of dehydration (very dry mouth, no urine for more than 8 hours, confused and drowsy) develop a fever (high temperature) have severe pain at the back of your throat have any other symptoms that appear life threatening. Call Healthline 0800 611 116 if you are unsure what to do.

Seek immediate medical help if you:

have difficulty breathing, eg, struggling for each breath or making a grunting noise with each breath
have great difficulty swallowing
develop a skin rash
are not able to drink much or shows signs of dehydration (very dry mouth, no urine for more than 8 hours, confused and drowsy)
develop a fever (high temperature)
have severe pain at the back of your throat
have any other symptoms that appear life threatening.

Call Healthline 0800 611 116 if you are unsure what to do.

How are the causes of a sore throat diagnosed?

Your doctor will ask questions about your symptoms and look in your mouth. They may take a throat swab to test for Streptococcus if you are at high risk of rheumatic fever or are at risk of spreading a strep throat infection, eg, you are a:

healthcare worker
residential care worker
food handler
teacher
childcare worker
student.

If glandular fever is suspected you may need to have a blood test.

How is a sore throat treated?

The treatment of a sore throat depends on the cause. A sore throat that is caused by a viral infection is usually treated by self-care measures such as:

pain relief medicines
drinking more fluids
eating soft foods
trying ice blocks
honey and lemon juice.

Antibiotics won't help a sore throat that is caused by a viral infection. Read more about what can I do to ease a sore throat.

If you have a sore throat that is caused by Streptococcus or strep throat and you are at high risk of rheumatic fever, antibiotics will be given. Antibiotics may also be given if you are at risk of spreading a strep throat infection, eg, if you are a:

healthcare worker
residential care worker
food handler
teacher
childcare worker
student.

The course of the antibiotics is usually for 10 days, and it is important that you or your child complete the full 10 days of antibiotics, even if you or your child start to feel better. This helps to stop strep throat from turning into rheumatic fever. Antibiotics can be given in a form of a capsule, liquid or as an injection.

What can I do to ease a sore throat?

To help soothe a sore throat you can:

drink plenty of cool or warm water or diluted juice
eat cool, soft food or warm soups
older children and adults may be able to gargle with warm salt water
suck on ice cubes
avoid smoking or smoky places
rest as much as you can
suck medicated throat lozenges (not for children)
take pain relief medication such as paracetamol or ibuprofen.

Learn more

Sore throat Ministry of Health, NZ
Rheumatic fever prevention programme Ministry of Health, NZ
Sore throat in children KidsHealth NZ
It starts with a sore throat East Bays Courier, Auckland
NZ children get better start to life NZ Government Press Release
Budget 2013 – additional $21.3m to fight rheumatic fever NZ Government Press Release
Coughs, colds and sore throats – antibiotics aren’t likely to help coughs, colds or sore throats Choosing Wisely, NZ

References

Sore throat Auckland Regional HealthPathways, NZ, 2020
Sore throat Ministry of Health, NZ

Credits: Health Navigator Editorial Team. Reviewed By: Dr Christine McIntosh BSc,MBChB, Dip. Paed. Dip. O&G, FRNZCGP Last reviewed: 11 Mar 2019 Page last updated: 28 Jun 2022

Medicines for sore throat

A sore throat is often caused by a viral infection, and the pain and discomfort usually eases after a few days. It often doesn't not need medication. But if the pain is very uncomfortable you can use the following medicines to ease the symptoms.

Medication	Description
Paracetamol or ibuprofen	Taking pain relief medicines such as paracetamol may ease your symptoms and may allow you to eat and drink more comfortably. Read more about paracetamol. You can also use ibuprofen, an anti-inflammatory medicine, to ease the pain but ibuprofen may not be suitable if you have some medical conditions. Read more about ibuprofen.
Throat products (lozenges, sprays and gargles)	Sore throat products are available as lozenges, sprays or gargles. Some contain anaesthetics (numbing agents) and may provide temporary relief from soreness. Most of these products can be used every 2–3 hours. Common examples include: Codral sore throat lozenges Difflam lozenges Difflam spray Difflam mouthwash Strepsils lozenges Strepfen intensive lozenge Cepacaine mouthwash. Talk to your pharmacist about the best pain relief for you or your child. Medicated throat lozenges are not suitable for children. Some lozenges have a high sugar content and may not be suitable for people with diabetes.
Cough suppressants	If your sore throat is because of an ongoing, continuous dry cough, a cough suppressant such as pholcodine or dextromethorphan may be helpful. Most cough and cold medications are not suitable for children.

When are antibiotics used for sore throat?

Most people don't need antibiotics for a sore throat because most sore throats are caused by viruses and antibiotics are not effective at killing viruses. Antibiotics don't make much difference to symptoms – you have a 50% chance of being better in 3 days without antibiotics, and within 3 days with them. In either case, with or without antibiotics, you have a 90% chance of being better in 7 days.

Antibiotics are needed in some cases — although it is not considered worthwhile to routinely prescribe antibiotics for most children, Māori or Pasifika children or those coming from crowded homes may benefit from taking antibiotics. This is because the chances of them developing other health problems such as ear infections, rheumatic fever or glomerulonephritis (inflammation of the kidneys) are higher than for most children.

If strep throat is diagnosed, your doctor will prescribe a 10-day course of antibiotics such as penicillin or amoxicillin. If you are given antibiotics, finish the full course to make sure the strep throat does not cause rheumatic fever. Children with strep throat need to take an oral antibiotic for at least 24 hours before they can return to school or daycare.