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Antibiotics for sore throat.

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

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

The Cochrane Database of Systematic Reviews
|April 24, 2004
PubMed
Summary

Antibiotics offer some benefits for sore throat, reducing symptoms and preventing complications like rheumatic fever and otitis media. However, their absolute benefit is modest, with many patients not needing treatment for symptom relief.

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Area of Science:

  • Infectious Diseases
  • Pharmacology
  • Public Health

Background:

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

Purpose of the Study:

  • To systematically assess the benefits of antibiotic use in managing sore throat.
  • To evaluate the impact of antibiotics on symptom duration and complication rates.

Main Methods:

  • A systematic literature search was conducted across multiple databases (CENTRAL, MEDLINE, EMBASE) from 1945 to 2003.
  • Included trials compared antibiotic treatment against a control group, assessing symptoms and suppurative/non-suppurative complications.
  • Data extraction and study screening were performed independently by two reviewers.

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Main Results:

  • Antibiotics significantly reduced the risk of acute rheumatic fever (OR=0.30), acute otitis media (OR=0.22), and quinsy (OR=0.16).
  • Symptom relief (headache, throat soreness, fever) was observed, with maximal effect around 3.5 days; overall symptom duration was shortened by approximately 16 hours.
  • Antibiotic effectiveness was greater when throat swabs for Streptococcus were positive (OR=0.16) compared to negative (OR=0.65).

Conclusions:

  • Antibiotics provide relative benefits for sore throat, particularly in reducing severe complications.
  • The absolute benefit for symptom relief is modest, with a number needed to treat of approximately 5 to prevent one sore throat at day three.
  • In settings with high complication rates, such as emerging economies, the number needed to treat may be lower, justifying antibiotic use more strongly.