EC Microbiology

Review Article Volume 16 Issue 1 - 2019

Management and Diagnosis of Bacterial Sore Throat in Primary Care

Faisal Khaled H Alhomayani1*, Faisal Abdulrahman Alkhudaydi2, Amin Saleh Alrabie2, Salim A Alharthi2, Mohammed Saleh Alkhudaydi2, Meshal Salem Alqahtani2 and Emad Ali Bawkar2

1 Assistant Professor of Adult Nephrology, College of Medicine, Taif University, Saudi Arabia

2 Medical intern, Taif University, Saudi Arabia

*Corresponding Author: Faisal Khaled H Alhomayani, Assistant Professor of Adult Nephrology, College of Medicine, Taif University, Saudi Arabia.
Received: December 29, 2019; Published: December 31, 2019



Sore throat is inflectional disease, caused by different types of viruses and bacteria. It is mostly treated by antibiotics, which is only needed in case of bacterial origin. Because of that the proper diagnosis and management is important, especially in case of bacterial infection. In this review we discuss the differential diagnosis and management of sore throat caused bacteria. We searched in detailed following electronic databases; (PubMed, Embase, Google scholar) for relevant studies published in English language with human subject only up to July,2019. The most typical source of sore throat is intense pharyngitis caused by self-restricting viral infections. Ache management with paracetamol (acetaminophen) or non-steroidal anti-inflammatory drugs (NSAIDs) for that reason stands for the mainstay of treatment. These drugs supply restricted ache alleviation but likewise sometimes trigger severe injury. Treatment of aching throat with antibiotics additionally gives moderate advantage in decrease of signs and symptoms and fever when the infection is bacterial, but their use might contribute to antibiotic resistance. Although a lot of instances of sore throat have a viral aetiology and also the danger of secondary problems is reduced, medical professionals typically suggest antibiotics. Though this could be since clinicians assume that individuals seeking treatment anticipate a course of antibiotics, actually soreness relief may be more vital to them.

keywords: Bacterial Sore Throat; Primary Care; Antibiotics

  1. Stephenson K. “Acute and chronic pharyngitis across the lifespan”. Lippincott’s Primary Care Practice5 (2000): 471-489.
  2. Perry M. “Management of sore throat”. Practice Nurse11 (2007): 15-19.
  3. Del Mar C., et al. “Antibiotics for sore throat”. Cochrane Database of Systematic Reviews 4 (2009).
  4. Cilliers AM. “Rheumatic fever and its management”. British Medical Journal7579 (2006): 1153-1156.
  5. DuBois D., et al. “Rapid diagnosis of group A strep pharyngitis in the emergency department”. Annals of Emergency Medicine 15 (1986): 157-159.
  6. Hayes CS and Williamson H Jr. “Management of Group A beta hemolytic streptococcal pharyngitis”. American Family Physician (2001).
  7. Shapiro NL and Cunningham MJ. “Streptococcal pharyngitis in children”. Current Opinion in Otolaryngology and Head and Neck Surgery 3 (1995): 369.
  8. Akhtar M., et al. “Telemedicine Physical Examination Utilizing a Consumer Device Demonstrates Poor Concordance with In-Person Physical Examination in Emergency Department Patients with Sore Throat: A Prospective Blinded Study”. Telemedicine and e-Health10 (2018): 790-796.
  9. Yamamoto S., et al. “Development and efficacy of a clinician-targeted refresher course for treating nonpneumonia respiratory tract infections”. Journal of General and Family Medicine4 (2018): 127-132.
  10. Gerber MA. “Nelson, Textbook of pediatrics”. International editions. 18.182. Group A Streptococcus. (2007): 1135-1139.
  11. American Academy of Pediatrics, Committee on Infectious Diseases. Red Book: Report of the Committee on Infectious Diseases (2006).
  12. Gerber MA., et al. “Prevention of rheumatic fever and diagnosis and treatment of acute Streptococcal pharyngitis. A scientific statement from the American Heart Association endorsed by the American Academy of Pediatrics”. Circulation (2009): 1541-1551.
  13. Hasenbein ME., et al. “Detection of multiple macrolide- and lincosamide-resistant strains of Streptococcus pyogenes from patients in the Boston area”. Journal of Clinical Microbiology 42 (2004): 1559-1563.
  14. Altamimi Saleh., et al. “Short versus standard duration antibiotic treatment for acute streptococcal pharyngitis in children”. Cochrane Database Systematic Review 21 (2009): CD004872.
  15. Shah D. “Can we shorten the duration of treatment for acute streptococcal pharyngitis?” Indian Pediatrics 46 (2009): 235-237.
  16. Pichichero ME., et al. “Pharmacodynamic analysis and clinical trial of amoxicillin sprinkle administered once daily for 7 days compared to penicillin V potassium administered four times daily for 10 days in the treatment of tonsillopharyngitis due to Streptococcus pyogenes in children”. Antimicrobial Agents and Chemotherapy 52 (2008): 2512-2520.
  17. Falagas ME., et al. “Effectiveness and safety of short-course vs long-course antibiotic therapy for group a beta hemolytic streptococcal tonsillopharyngitis: a meta-analysis of randomized trials”. Mayo Clinic Proceedings 83 (2008): 880-889.
  18. Casey JR and Pichichero ME. “Symptomatic relapse of group A beta-hemolytic streptococcal tonsillopharyngitis in children”. Clinical Pediatrics4 (2007): 307-310.
  19. Casey JR and Michael Pichichero. “Meta-analysis of cephalosporin versus penicillin treatment of group A streptococcal tonsillopharyngitis in children”. Pediatrics 113 (2004): 866-7882.
  20. Casey JR and Michael Pichichero. “The evidence base for cephalosporin superiority over penicillin in streptococcal pharyngitis”. Diagnostic Microbiology and Infectious Disease 57 (2007): 39-45.
  21. Casey JR and Michael Pichichero. “Meta-analysis of cephalosporin versus penicillin treatment of group A streptococcal tonsillopharyngitis in children”. Pediatrics 113 (2004): 866-882.
  22. Bisno AL. “Are cephalosporins superior to penicillin for treatment of acute streptococcal pharyngitis?”. Clinical Infectious Diseases 38 (2004) 1535-1537.
  23. Norton LE., et al. “Improving Guideline-Based Streptococcal Pharyngitis Testing: A Quality Improvement Initiative”. Pediatrics1 (2018).
  24. Sadeghirad B., et al. “Corticosteroids for treatment of sore throat: systematic review and meta-analysis of randomised trials”. British Medical Journal 358 (2017): j3887.

Faisal Khaled H Alhomayani., et al. “Management and Diagnosis of Bacterial Sore Throat in Primary Care”. EC Microbiology  16.1 (2020): 01-10.