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Pharmacy First: Sore throat — part 1

This CPD module is the latest in our series designed to support pharmacists in delivering the Pharmacy First service in England. It covers assessment and clinical decision-making regarding acute sore throat. After completing it you will be able to conduct a simple examination of the throat; know which conditions and red flags require referral; and use a clinical scoring system to assess the likelihood of bacterial infection.

Key facts

  • Around 90 per cent of sore throats that present in pharmacy will be caused by viral infection
  • If the sore throat has lasted seven days or longer and shows no signs of settling, the patient should be referred
  • Clinical scoring systems such as FeverPAIN for the Pharmacy First scheme have some predictive value for infections more likely to benefit from antibiotic treatment
  • Examining a patient’s throat is a necessary part of using a clinical scoring system
  • Streptococcal (bacterial) throat infections are more likely in children of school age 
  • Antibiotics need careful targeting and even so, may have a limited effect on outcome (on average they reduce the duration of symptoms by about 16 hours) 
  • Self-care with OTC analgesics and medicated lozenges are the mainstay of management for sore throats

Contributing authors: Professor Alison Blenkinsopp and Dr Martin Duerden

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