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Antibiotics for sore throat.

C B Del Mar¹, P P Glasziou, A B Spinks

¹Centre for General Practice, University of Queensland Medical School, Brisbane Queensland 4006, Australia. c.delmar@mailbox.uq.edu.au

The Cochrane Database of Systematic Reviews

|May 5, 2000

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Antibiotics offer modest benefits for sore throat, reducing symptom duration by about half a day and preventing some complications. However, many patients receive antibiotics without deriving significant benefit.

Area of Science:

Infectious Diseases
Pharmacology
General Practice

Background:

Sore throat is a common ailment, often self-limiting, yet antibiotics are frequently prescribed.
The efficacy of antibiotic treatment for sore throat requires careful evaluation due to potential overuse.

Purpose of the Study:

To systematically assess the benefits of antibiotic therapy in managing sore throat symptoms and complications.
To evaluate the impact of antibiotics on both symptomatic relief and the incidence of suppurative and non-suppurative complications.

Main Methods:

A systematic literature review was conducted, searching databases like MEDLINE and the Cochrane Library from 1945 to 1999.
Included studies were randomized controlled trials comparing antibiotic treatment against placebo for sore throat.

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Outcomes assessed included symptom severity (soreness, headache, fever) and the occurrence of complications.

Main Results:

Antibiotics significantly reduced the incidence of acute rheumatic fever (OR=0.30), acute otitis media (OR=0.22), and quinsy (OR=0.18).
A trend towards protection against acute glomerulonephritis was observed, though not statistically significant.
Symptom duration was shortened by antibiotics, with maximal effect around day 3, but 90% of patients were symptom-free by one week regardless of treatment.

Conclusions:

Antibiotics provide relative benefits for sore throat but absolute benefits are modest.
Widespread antibiotic use for sore throat in Western societies leads to many individuals being treated without significant advantage.
While antibiotics shorten symptom duration, the overall impact is limited, necessitating a balanced approach to prescribing.