Sore throat in adults

Also called pharyngitis

While sore throats can be painful and cause discomfort when swallowing, most are caused by a virus and will go away within a few days without needing medication. However, sometimes a sore throat can be a sign of something more serious and may require treatment with an antibiotic.

What causes sore throat?

A sore throat is a common symptom of a number of illnesses ranging from the common cold to glandular fever. When bacteria or viruses infect the tissues at the back and sides of the throat, the body then tries to fight the infection, which can cause the glands (lymph nodes) in the neck to swell and become tender.

Sore throat caused by viruses

Approximately 90% cases of sore throat are caused by viruses, and will clear up within a week.

  • Viral sore throats cannot be treated by antibiotics. 
  • Colds are caused by viruses and sore throats are a common symptom of a cold.  
  • Sometimes viruses cause a sore throat without a runny nose or cough.

Sore throat caused by bacteria

The most common type of sore throat caused by bacteria is as a result of a Streptococcus infection (often known as Strep throat).

  • This causes about 20% of persistent sore throats. 
  • If strep throat is not treated with antibiotics it can cause rheumatic fever in at-risk children.
  • Rheumatic fever can cause permanent damage to the heart.
  • In New Zealand, Māori and Pacific children are most at risk of developing rheumatic fever and should see a doctor with any sore throat.

Symptoms of sore throat

The main symptoms of a sore throat are:

  • A painful or itchy throat, especially when swallowing.
  • Difficulty swallowing.
  • A cough, hoarseness, red eyes, and runny nose (usually not seen with Strep throat).

Symptoms of strep throat may also include:

  • A fever (greater than 38.5 degrees Celsius).
  • Swollen tonsils, sometimes with white patches.
  • Swollen or tender glands in their neck.
  • Headache.
  • Stomach pain.

When to see your doctor about a sore throat

Maori and Pacific Island children are at high risk of developing rheumatic fever and should see a doctor if they show any signs of sore throat. 

For everyone else, you should see your GP or nurse if symptoms are not improving after 48 hours or if you:

  • are not able to drink much or shows signs of dehydration (very dry mouth, no tears with crying and no urine for more than 8 hours).
  • have great difficulty swallowing.
  • have neck stiffness or ear pain.
  • have swollen glands (feel for tender lumps in the neck) that are getting bigger.
  • have any other symptoms you are concerned about.

Seek immediate medical help if you:

  • have difficulty breathing, i.e: struggling for each breath or making a grunting noise with each breath.
  • develops a skin rash.
  • have any other symptoms that appear life-threatening.

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

Diagnosis and treatment of strep throat

  • If strep throat is suspected, your GP or nurse will take a throat swab to be tested.
  • If strep throat is diagnosed, standard treatment is a 10-day course of penicillin or amoxicillin.
  • Children need to stay away from school or day care for at least 24 hours after they start antibiotics, to reduce the risk of spreading the strep bacteria.
  • You must finish the full course of antibiotics to make sure the strep throat does not cause rheumatic fever.

What can I do to ease sore throat?

  • Eat cool, soft food and drinking cool or warm liquids, such as chicken broth or apple juice.
  • Drink plenty of clear liquids, especially if you have a high temperature (fever).
  • Avoid smoking and smoky environments.
  • Rest as much as you can. Take time off work until you feel well enough to participate in normal activities.
  • Gargle and rinse your mouth out with salt water.
  • Suck throat lozenges  to help keep your throat lubricated.
  • Take pain relief medication such as paracetamol or ibuprofen.
  • Keep warm and comfy.

Learn more

Sore throat  NZ Ministry of Health
Rheumatic fever prevention programme NZ Ministry of Health
Sore throat in children KidsHealth NZ
It starts with a sore throat East Bays Courier, Auckland, 7 August 13
NZ children get better start to life  NZ Government Press Release, 8 July 2013
Budget 2013: Additional $21.3m to fight rheumatic fever  NZ Government Press Release, 21 May 2013 

Credits: Editorial team.