• Reassure the individual that a sore throat is generally self limiting, with most immunocompetent people recovering after 7 days with or without antibiotic treatment.
• Advise the person to see a healthcare professional if they do not improve. Explain that they should seek urgent medical attention if they develop any difficulty breathing, stridor, drooling, a muffled voice, severe pain, dysphagia, or if they are not able to swallow adequate fluids or become systemically very unwell.
• Advise regular use of paracetamol or ibuprofen to relieve pain and fever.
• Provide advice regarding food and drink to avoid exacerbating pain (e.g. avoid hot drinks).
• Suggest the use of simple mouthwashes (e.g. warm salty water) at frequent intervals until the discomfort and swelling subside.
• Discuss the role of antibiotics (see Prescribing an antibiotic).
• If the person is immunosuppressed:
• If they are taking a disease-modifying anti-rheumatic drug (DMARD) or carbimazole, tell them to stop this while waiting for the result of a full blood count (FBC). Arrange to contact them later with the result and explain that you will seek specialist advice.
• Stress that they should seek immediate medical advice if they become systemically unwell.
• Explain to all other people who are immunosuppressed that you will seek urgent specialist advice. This includes people who:
• Have leukaemia, aplastic anaemia, asplenia or HIV/AIDS.
• Are on chemotherapy or who are taking an immunosuppressive drug following a transplant. Advise them not to stop their medication unless after your discussion with the specialist they are advised to do so.

In depth