Sore throat: causes, treatments and effective remedies

Sore throat is one of the most common complaints at all ages. It can be a mild symptom of a cold or a sign of a bacterial infection requiring antibiotics. Knowing how to identify it helps you decide when to watch at home and when to see a doctor.

At Clínica Eupnea, Palamós, our ENT and general medicine specialists assess all causes — viral, bacterial, allergic or reflux — and offer tailored treatment.

Main causes of sore throat

• Viral infections (80-90%): common cold, flu, COVID-19, mononucleosis
• Bacterial infections: streptococcal pharyngotonsillitis (the best known)
• Allergies: allergic rhinitis with post-nasal drip
• Laryngopharyngeal reflux: 'silent reflux' with morning burning and hoarseness
• Dry air: heating, AC, low humidity
• Irritants: tobacco smoke, pollution, chemicals
• Vocal overuse: singing, shouting, prolonged speaking
• Less common: peritonsillar abscess, ENT cancer (suspect in >50 yrs, smokers)

Viral or bacterial? How to tell

The Centor criteria help suspect bacterial cause:

• Fever above 38°C
• Absence of cough
• Tender cervical adenopathy
• Tonsillar exudate or plaques
• Age 3-14 (+1 point)

3-4 criteria → high probability of strep. Confirmed with a rapid strep antigen test and, if needed, a throat culture.

Home remedies that work

• Plenty of fluids: water, hot infusions, broth — keep mucosa lubricated
• Honey (better with lemon): demulcent and mild antibacterial — not for under 1 year
• Saltwater gargling: 1 tsp salt in a glass of warm water, 2-3 times/day
• Lozenges: sugar-free, some with mild topical anaesthetics
• Humidified air: especially in winter
• Vocal rest: avoid shouting and over-talking
• Paracetamol or ibuprofen: for fever and pain, as advised

Medical treatment

Treatment depends on the cause:

• Viral: symptomatic — analgesics, hydration, rest. No antibiotics.
• Strep: antibiotic (amoxicillin or penicillin) for 10 days. Complete the course to prevent complications like rheumatic fever.
• Reflux: dietary measures, antacids, short PPI courses
• Allergy: antihistamines, nasal corticosteroids, allergen avoidance
• Recurrent tonsillitis: tonsillectomy assessment (>5 episodes/year sustained)