Acute Sore Throat

Acute sore throat
CKS
FeverPAIN

Avoid antibiotics as 82% resolve in 7 days without, and pain only reduced by 16 hours. Use FeverPAIN Score: Fever in last 24h, Purulence, Attend rapidly under 3d, severely Inflamed tonsils, No cough or coryza).  Score 0-1: 13-18% streptococci, use NO antibiotic strategy; 2-3: 34-40% streptococci, use 3 day back-up antibiotic; >4: 62-65% streptococci, use immediate antibiotic if severe,  or 48hr short back-up prescription.                                       

Always share self-care advice & safety net.

Antibiotics to prevent Quinsy NNT >4000.

Antibiotics to prevent Otitis media NNT 200.

10d penicillin lower relapse vs 5d in <18yrs.

Phenoxymethylpenicillin

500mg QDS or 1G BD (QDS when severe)

Child

1 to 11 months: 62.5mg QDS or 125mg BD

1 to 5 years: 125mg QDS or 250mg BD

6 to 11 years: 250mg QDS or 500mg BD

12 to 17 years: 500mg QDS or 1000mg BD

5-10 days

Penicillin Allergy: Clarithromycin

250-500mg BD

Child

1 month to 11 years:

Under 8 kg - 7.5mg/kg BD

8 to 11 kg - 62.5mg BD

12 to 19 kg: 125mg BD

20 to 29 kg - 187.5mg BD

30 to 40 kg - 250mg BD

 

12 to 17 years: 250mg to 500mg BD

5 days

Penicillin Allergy in Pregnancy: Erythromycin

500mg QDS

5 days