Guidance
This guideline sets out an antimicrobial prescribing strategy for acute sore throat. It aims to limit antibiotic use and reduce antimicrobial resistance. Acute sore throat is often caused by a virus, lasts for about a week, and most people get better without antibiotics. Withholding antibiotics rarely leads to complications.
February 2023: We have reinstated our prescribing guidance for children and young people, because the December 2022 NHSE interim guidance on group A streptococcus that replaced it has been withdrawn. See Group A Streptococcus: withdrawal of NHSE interim guidance.
See a 3-page visual summary of the recommendations, including a table to support prescribing decisions.
There is also a NICE guideline on antimicrobial stewardship: systems and processes for effective antimicrobial medicine use.
Recommendations
This guideline includes recommendations on:
- managing acute sore throat, including advice when an antibiotic is not needed
- choice of antibiotic when a back-up or immediate prescription is needed
- self-care
Who is it for?
- Health professionals
- Adults with acute sore throat and their families and carers
Is this guideline up to date?
April 2019: We have found no new evidence that affects the recommendations. For more information, see the surveillance decision.
Guideline development process
How we develop NICE guidelines
NICE worked with Public Health England to develop this guidance.
This guideline partially updates and replaces NICE guideline CG69 (Published July 2008).
Your responsibility
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.
All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.
Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.