Bacterial Pharyngitis
Bacterial pharyngitis is infection of the throat and tonsils by bacteria, with group A streptococcus the main reason targeted testing and antibiotics are considered.
Key takeaways
- Cough, runny nose, hoarseness and mouth ulcers favour a viral cause rather than streptococcal infection.
- Clinical scores estimate probability but cannot confirm every case; rapid antigen or culture testing may be appropriate.
- Antibiotics have a defined role in confirmed or strongly suspected streptococcal disease, not every sore throat.
The listings below do not establish a bacterial cause; age, examination, allergy and testing should guide treatment.
Features that guide testing
Sudden sore throat, fever, tender neck nodes, tonsillar exudate and absence of cough increase suspicion. Scarlet-fever rash can accompany streptococcal infection. Clinicians also assess for glandular fever, which may cause prolonged fatigue and can produce a rash after certain antibiotics.
Treatment and symptom relief
Fluids and appropriate pain relief support recovery. When indicated, a narrow-spectrum antibiotic is generally preferred; choice changes with immediate-type penicillin allergy. Persistent severe symptoms require reassessment for an abscess or another diagnosis rather than automatic antibiotic escalation.
When to seek urgent care
Seek urgent care for breathing difficulty, drooling or inability to swallow fluids, a muffled voice, severe one-sided swelling, neck stiffness, dehydration, confusion or rapid deterioration.