Sore Throat Treatment at home and when do you really need an antibiotic?

You often feel pain and irritation in your throat during a cold, but the truth is that a sore throat can happen for many other reasons, such as allergies, acid reflux, or even overusing your voice. Each cause has its own treatment method; for instance, antibiotics treat bacterial infections but not viruses.

And since allergies have their own medications that relieve symptoms — how then can you treat a sore throat depending on its cause? And what is the best medicine to relieve it?

What Is a Sore Throat?

A sore throat is a sensation of pain and irritation in the back of the throat caused by inflammation of the tissues lining it, and you may also feel pain when swallowing or talking.

Sore throat is divided into two types:

• Acute sore throat: lasts 3–10 days and represents most cases.
• Chronic sore throat: lasts more than 10 days (often several weeks) or keeps returning after improvement.

Causes and Symptoms of Sore Throat

The causes of sore throat differ from one person to another, and the accompanying symptoms may also vary depending on the cause. Below are the main causes:

1. Viral Infections

Viruses are the most common cause of sore throat — 50–80% of adult cases are viral, such as:

• Rhinoviruses
• Influenza virus
• Adenovirus
• Coronavirus
• COVID-19 virus
• Epstein–Barr virus

Viruses may also cause other cold-like symptoms including fever, nasal congestion, and cough. However, sore throat can sometimes be the only or main symptom. Symptoms usually disappear within 1–3 weeks.

2. Bacterial Infections

Sore throat can also be caused by bacterial infections, which often lead to fever and may cause complications such as abscesses, ulcers, or swollen lymph nodes.

A sore throat from a bacterial infection can be treated with appropriate antibiotics to relieve symptoms.

3. Strep Throat

About 10% of sore throat cases in adults and 30% in children are caused by Streptococcus bacteria. It may also come with other symptoms like fever.

If you have a sore throat without any other symptoms, it’s unlikely to be strep throat.

It occurs due to Group A Streptococcus bacteria, and common symptoms include:

• Throat pain
• Fever
• Swollen lymph nodes in the neck
• Redness in the throat
• Visible pus or white patches on the tonsils

Diagnosis is made with a throat swab to detect the bacteria, and the doctor prescribes an appropriate antibiotic.

Strep throat is highly contagious — even without fever, you remain contagious for up to 24–48 hours after starting antibiotics.

4. Allergies

Allergies can also cause sore throat. Seasonal allergies — for example, to pollen — may irritate the nose and throat.

There is no permanent cure for allergy-related sore throat, but treatment focuses on controlling the body’s allergic response to prevent symptoms such as nasal discharge or congestion. In such cases, antihistamines and allergy medications may be prescribed.

5. Acid Reflux

Aside from allergies and infections, gastroesophageal reflux can cause sore throat, especially in severe or chronic cases, when stomach acid rises up into the esophagus and irritates the throat lining.

Treatment involves dietary changes and medications that control acid secretion or reflux.

6. Environmental Irritants

In addition to allergens, other inhaled irritants can cause throat pain or inflammation — such as air pollution, smoke, and chemical fumes.

If you live in an area exposed to wildfire smoke or other pollutants, consider using an air purifier and keeping windows closed, especially when air quality is poor.

7. Lifestyle Factors

Throat irritation can also result from certain behaviors such as:

• Overusing your voice: Just as muscles get fatigued, speaking or singing for long periods can injure throat tissues. It’s recommended to rest your voice for 10 minutes after every hour of speaking to avoid soreness.
• Mouth breathing: Often linked to various health problems, but the most direct and immediate effect is a dry or sore throat. Try to avoid mouth breathing and use a saline nasal spray to clear your nasal passages if they’re blocked.

8. Throat Cancer

Although rare, a sore throat that doesn’t go away can be a sign of throat cancer. It’s often accompanied by other symptoms such as:

• Difficulty swallowing
• Ear pain
• Voice changes
• Nosebleeds
• Chronic cough
• Weight loss
• Swelling of the eye, jaw, throat, or neck

Throat cancer is more common among people who:

• Smoke or use tobacco products
• Drink excessive alcohol
• Have HPV infection
• Have poor oral hygiene
• Have Epstein–Barr virus infection
• Have vitamin deficiencies or an unhealthy diet

Treatment of Sore Throat

Treatment depends on the underlying cause. For viral infections, the condition usually resolves within a week. During this time, your doctor may prescribe medicines to relieve symptoms, such as:

• Paracetamol: pain reliever
• Ibuprofen: pain reliever and anti-inflammatory
• Throat lozenges
• Throat sprays containing an antiseptic anesthetic such as phenol or cooling ingredients such as menthol or eucalyptus

Other treatment options vary depending on the cause:

1. Antibiotics

Antibiotics are prescribed only for bacterial infections causing sore throat. Most patients need them for no longer than 10 days.

2. Antihistamines (Allergy Medications)

These are prescribed to relieve allergy-related symptoms, including sore throat.

3. Acid Reflux Medications

If reflux is the cause, the doctor may prescribe:

• Antacids to neutralize stomach acid
• H2 blockers such as famotidine to reduce acid production
• Proton pump inhibitors (PPIs) such as omeprazole to block acid secretion

Do You Need Antibiotics for a Sore Throat?

Antibiotics treat bacterial infections, not viral ones. Their use depends on the doctor’s diagnosis that the cause is bacterial.

In such cases, antibiotics help prevent serious complications such as bronchitis and rheumatic fever.

Antibiotics can reduce throat pain within about one day and decrease the risk of rheumatic fever by more than two-thirds.

You must complete the full antibiotic course as prescribed, since stopping early may allow some bacteria to survive.

What Is the Best Medicine for Sore Throat?

1. Strepsils Honey & Lemon

Strepsils Honey Lemon 36Tab are Soothing lozenges that help relieve pain associated with sore throat or laryngitis.

2. Strepsils Menthol

Strepsels Menthol 36Tab are soothing lozenges that help relieve pain associated with sore throat or laryngitis.

3. Vicks VapoDrops Menthol with Orange (36 lozenges)

Vicks Vapodrops Menthol With Orange 36 Tablets with Orange are Natural lozenges that help relieve sore throat, cough, and cold symptoms.

4. Telfast 120 mg

Telfast 120 Mg 15 Tablets contains fexofenadine, an antihistamine that reduces allergy symptoms, thus relieving allergy-related sore throat.

5. Betasept Mouthwash

Betasept Mouthwash Rinse 1% 130Ml contains povidone-iodine, an antiseptic that eliminates harmful mouth bacteria, relieves throat congestion, and improves breath.

6. Panadol Cold & Flu Steam Inhalation

Panadol Cold+Flu Vapour Release 10 sachets helps relieve pain and cold symptoms, including sore throat and nasal congestion.

7. FluShield 1000 Jamieson

Flu Shield 1000 Jamieson is a dietary supplement containing Echinacea extract (1000 mg per capsule) that helps relieve cold symptoms such as sore throat and supports the immune system.

Home Remedies for Sore Throat

There are many home methods that can help relieve sore throat, although they are not substitutes for prescribed medications:

1. Salt-Water Gargle

Gargling warm salt water soothes inflammation and reduces mucus and bacteria. According to the American Osteopathic Association, patients should gargle at least once every hour.

2. Chamomile Tea

Chamomile tea has anti-inflammatory and antioxidant properties that can soothe sore throat and support immune function.

3. Peppermint

Peppermint not only freshens breath but also has anti-inflammatory, antibacterial, and antiviral properties. Its menthol content thins mucus and eases sore throat and cough.

4. Marshmallow Root

It contains a mucus-like substance that coats and soothes the throat and may help with respiratory irritation.

5. Steam or Humidity

Dry air can worsen sore throat, while moisture helps. Inhaling steam may relieve irritation:

• Add boiling water to a bowl.
• Place a towel over your head and breathe normally, letting steam enter through your mouth and nose.
• Continue for 10–15 minutes.

6. Rest 

Getting enough sleep is crucial. Severe sleep deprivation — even one night — increases inflammatory proteins.

Also, rest your voice by avoiding shouting, loud talking, or singing, which can worsen irritation.