What to do if you have a sore throat

You get a sore throat when your pharynx is inflamed. In the majority of cases, the cause is a virus, i.e. it may be that your common cold or attack of flu is spreading to your throat, or that you have caught something more specific like one of the adenoviruses that affect the upper respiratory tract. This means that treatment with an antibiotic is a complete waste of time. Antibiotics have no effect on viruses. But, in about 15% of cases, you find what is usually called a Strep throat. This is an infection caused by the streptococcus bacterium. It is more likely during the colder months and often spreads between social groups at home or work.

The way to distinguish between a viral and bacterial infection is quite simple. Strep throat is usually associated with a high temperature, i.e. running a fever, some difficulty in swallowing, swollen glands in the neck and, in more rare cases, difficulty in breathing. To make a positive diagnosis, it is possible to take a swab to culture in the lab, but this is not usually necessary. A physical examination is usually sufficient to confirm the probable cause - a course of Azithromycin is usually effective to relieve the symptoms. A virus is more likely to follow a runny nose and you are less likely to feel sick in yourself. The standard treatment for a viral infection is to drink more fluids, gargle with warn salt water and take pain relievers

However, the problem may be more specific to the tonsils. At first, the symptoms may appear to be no more than a sore throat. But if the symptoms persist for several months, it will become increasingly likely that this is tonsillitis caused by a bacterium. The first indication that this is not a simple sore throat will be a pain in the ears. This is usually called a "referred" or "sympathetic" pain, i.e. there is nothing immediately wrong with your hearing, but your ears hurt in sympathy with the infected part of the body. The next sign is that your tonsils grow red, swell and develop a coating of white patches. Your voice is also likely to change. Within a few days, the pain is likely to become more severe and, in most cases, topical anesthetics are prescribed. These are thick liquids that coat your tonsils when you swallow. Because the cause will prove to be bacterial simply because of the passage of time, Azithromycin is a standard and effective treatment in combination with pain management medication. In many countries, the standard treatment used to be the removal of the tonsils if the inflammation persisted. Surgery is now reserved for only the most serious and long-lasting cases.