Sore Throat (Pharyngitis)

Sore throat pain can range from slightly scratchy to so severe that even swallowing saliva hurts. Most sore throats are caused by viruses (common cold, influenza or mononucleosis) and usually last several days. Antibiotics will not help cure these types of sore throats and may even cause unwanted side effects, such as a rash, nausea, abdominal pain and/or diarrhea. Sore throats can also be caused by nasal drainage going down the back of your child’s throat, either due to a viral illness (cold) or due to allergies.

Strep throat

Some sore throats are caused by a Streptococcus bacteria (strep throat). Strep throat symptoms may develop 2–5 days after exposure. Strep throat is less likely if your child has a cough or does not have a fever. If your child’s doctor is concerned about strep, he or she will perform a rapid strep test or throat culture. If positive, your child’s doctor will prescribe an antibiotic. The main reason to treat strep throat is to prevent rheumatic fever, a serious heart complication. Even though your child will feel better quickly, he or she must complete the entire course of antibiotics to prevent rheumatic fever. Antibiotics may begin up to nine days after the start of symptoms and still be effective in preventing rheumatic fever. Patients are no longer contagious and can return to school after taking antibiotics for 12 hours. Return to the doctor for a re-check if your child’s fever or throat pain is not improving after 48–72 hours of antibiotics.

Do white spots on my child’s tonsils mean strep?

Viruses such as mononucleosis and adenovirus can also cause exudates, or white spots, on the tonsils. If you are concerned about strep throat, take your child to his or her doctor to have him or her tested.

Tips for treating a sore throat

• Use acetaminophen or ibuprofen, dosed appropriately for your child’s weight
• If sore throat is caused by post nasal drainage due to allergies, an over-the-counter allergy medication (cetirizine or loratidine) may help.
• Older children can gargle with warm salt water every couple of hours using a mixture of ½ teaspoon of salt dissolved into 4 ounces of water (do not swallow)
• Drink warm beverages and avoid consuming acidic or spicy foods
• Drinking ice water or eating cool items such as frozen yogurt, popsicles, or ice cream may also help
• A throat lozenge may also help, but only give to your child if you trust them not to choke on it. 

Reviewed by Sara Laule, MD

Updated March 2019