Most sore throats come with a cold and get better without antibiotics. The signs that point to strep throat, home remedies that actually help and when to see a doctor.
What causes a sore throat?
Most sore throats are caused by viruses – the same ones behind colds, flu and COVID-19. They usually get better on their own within about a week.
Strep throat is caused by bacteria (group A Streptococcus). It's most common in children aged 5 to 15, but adults get it too. Other causes include allergies and postnasal drip, dry air, smoke, acid reflux and straining your voice.
Virus or strep throat?
| More likely a virus | More likely strep throat |
|---|---|
| Cough, runny nose or hoarse voice | No cough |
| Comes with other cold symptoms | Starts suddenly, with pain when swallowing |
| Mild fever or none | Fever |
| Red, irritated throat | Red, swollen tonsils, sometimes with white patches or streaks of pus |
| Tiny red spots on the roof of the mouth, or swollen, tender glands in the front of the neck |
You can't tell for sure by looking. A rapid strep test or throat culture at a clinic or urgent care confirms it in minutes to a day or two.
What helps a sore throat
- Warm drinks such as tea with honey (never give honey to babies under 1), or cold drinks and ice pops – whichever feels better.
- Gargle with warm salt water: about half a teaspoon of salt in a glass of warm water, several times a day.
- Lozenges or hard candy keep your throat moist (not for young children, who could choke).
- A humidifier helps if the air is dry, especially at night.
- Rest your voice, and avoid smoke.
- Pain relief: ibuprofen or acetaminophen ease the pain and any fever. Follow the label.
When are antibiotics needed?
Only for a bacterial infection such as strep throat. Antibiotics don't help a viral sore throat – they won't make you better faster, and they can cause side effects such as diarrhea and allergic reactions, and make antibiotic resistance more likely.
If a test confirms strep, doctors usually prescribe penicillin or amoxicillin. People with a penicillin allergy get a different antibiotic. Take every dose, even when you feel better – treating strep properly prevents rare but serious problems such as rheumatic fever and abscesses. You can usually go back to work or school once you've had no fever and taken antibiotics for at least 12 hours.
PharmacyFarm dispenses antibiotics such as amoxicillin only after our pharmacist has verified your prescription. Our guide to common antibiotics explains the differences between them.
When to see a doctor
See a doctor if:
- A sore throat lasts more than a week, or keeps coming back
- You have signs of strep throat (see the table above)
- You have a fever over 101°F (38.3°C), or a rash with your sore throat
- The pain is severe, or one side is much worse than the other
Get urgent care (or call 911) if you have trouble breathing, can't swallow your saliva or are drooling, can't open your mouth fully, your voice sounds muffled, or there's swelling on one side of your neck.