Pharyngitis

Key takeaways

• Cough and runny nose favour a viral cause, while examination and testing may be needed when streptococcal infection is suspected.
• Fever, tender neck glands and tonsillar coating can raise suspicion for streptococcal infection, but symptoms alone do not reliably confirm it.
• Antibiotics do not help viral sore throat; local testing guidance, allergy history and individual risk guide use when bacterial infection is likely or confirmed.

The listings below do not establish the cause of a sore throat; antimicrobial treatment should follow clinical assessment and testing where indicated.

What helps distinguish the cause?

Cough, hoarseness, mouth ulcers and a runny nose favour a viral illness. Sudden sore throat with fever, tender neck glands and no cough can increase the likelihood of streptococcal infection, but examination findings overlap. A rapid antigen test or throat culture may change the treatment decision.

Where do medicines fit?

Fluids and suitable pain relief can help symptoms while the illness settles. When an antibiotic is indicated, selection follows the likely organism, allergy history and local guidance; catalogue entries such as cefixime or cefuroxime are not interchangeable recommendations for a sore throat.

When to seek urgent care

Seek urgent care for difficulty breathing, inability to swallow saliva, drooling, a muffled voice, severe one-sided swelling, neck stiffness, dehydration or rapid deterioration. A rash with fever or a very unwell child also needs prompt assessment.