Cochrane for Clinicians

Putting Evidence into Practice

Antibiotics for Sore Throat

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Am Fam Physician. 2014 Jul 1;90(1):23-24.

Author disclosure: No relevant financial affiliations.

Clinical Question

Should we prescribe antibiotics for sore throat?

Evidence-Based Answer

Compared with placebo, antibiotics can shorten the duration of sore throat symptoms by about 16 hours and can reduce complications. In countries where the absolute rates of complications are higher, antibiotic therapy is more likely to be effective. The effectiveness of antibiotic therapy is greatest in persons with streptococcal pharyngitis. (Strength of Recommendation: A, based on consistent, good-quality patient-oriented evidence.)

Practice Pointers

Sore throat is commonly encountered in primary care, accounting for approximately 1.3% of outpatient visits, and is often treated with an antibiotic.1,2 Although antibiotics are useful for treating sore throat with bacterial etiology, the cause of sore throat is not always confirmed at the time of treatment, and most cases are caused by nonbacterial agents.3 Antibiotic prescribing rates vary considerably among physicians, and high prescribing rates increase costs and microbial resistance.

In this Cochrane review,

The practice recommendations in this activity are available at


Spinks A, Glasziou PP, Del Mar CB. Antibiotics for sore throat. Cochrane Database Syst Rev. 2013;(11):CD000023.


1. Hing E, Hall MJ, Xu J. National Hospital Ambulatory Medical Care Survey: 2006 outpatient department summary. Natl Health Stat Report. 2008;(4):1–31.

2. Linder JA, Bates DW, Lee GM, Finkelstein JA. Antibiotic treatment of children with sore throat. JAMA. 2005;294(18):2315–2322.

3. Shulman ST, Bisno AL, Clegg HW, et al. Clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis: 2012 update by the Infectious Diseases Society of America. Clin Infect Dis. 2012;55(10):e86–e102.

These are summaries of reviews from the Cochrane Library.

The series coordinator for AFP is Corey D. Fogleman, MD, Lancaster General Hospital Family Medicine Residency, Lancaster, Pa.

A collection of Cochrane for Clinicians published in AFP is available at

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