This site is intended for Healthcare Professionals only


Pharmacy First: Sore throat – part 2

This CPD module is the latest in our series designed to support pharmacists in delivering the Pharmacy First service in England. It covers the clinical management of acute sore throat.


The NHS wants more episodes of care to be completed by community pharmacists as part of its strategy for managing demand in primary care. This is the thinking behind the new Pharmacy First service in England.

Last month’s module looked at assessing patients with sore throat, the latest in our series designed to support pharmacists to deliver common conditions services such as Pharmacy First.   

This module covers the management of sore throat. Drawing on the NICE Sore throat (acute): antimicrobial prescribing guideline [NG84] and CKS acute sore throat guideline, it looks at decision-making regarding OTC medicines but also covers self-care advice and the small number of occasions when a sore throat might benefit from antibiotics. 

The module also deals with communicating with patients or carers about the reasons for any treatment decisions, including pre-empting and responding to concerns when the decision is not to offer an antibiotic.

Contributing authors: Professor Alison Blenkinsopp and Dr Martin Duerden

Key facts

  • NICE recommends paracetamol for relief of pain or fever in sore throat or, if preferred and suitable, ibuprofen
  • Medicated lozenges such as those containing benzocaine, hexylresorcinol or flurbiprofen may help to reduce pain in adults
  • In the minority of cases where an antibiotic is offered, it is still important to advise on the use of analgesics and self-care measures
  • Health literacy may be poor; one-third of adults consider that antibiotics work for viral and fungal infections as well as bacterial infections
  • Many patients are satisfied if listened to carefully, examined thoroughly and provided with a reasoned explanation as to why an antibiotic may not be required, with alternatives recommended for relieving symptoms
  • Pharmacy First service-specific PGDs define the inclusion and exclusion criteria for different antibiotics in sore throat. If an antibiotic is issued, symptom relief should also be advised
  • For patients whose clinical score does not warrant antibiotics, advise returning if they do not feel better after three to five days, or if they are feeling worse
Copy Link copy link button