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Doctors should not prescribe “precious” antibiotics for most people with sore throats and should recommend drugs like paracetamol, new guidelines say. The National Institute for Health and Care Excellence said most sore throats were caused by viral infections, which cannot be treated by antibiotics. But research suggests antibiotics are prescribed in 60% of sore throat cases. NICE said it was “vital” the medicines were only used when effective because of the rise of antibiotic resistance. The overuse of antibiotics is making infections harder to treat by creating drug-resistant superbugs.

Acute sore throat, including pharyngitis and tonsillitis, can be caused by a bacterial or viral infection, with symptoms usually improving by themselves within a week. New guidelines from NICE and Public Health England, which aim to limit the use of antibiotics, said doctors should only be prescribing the medicines for more severe cases that are likely to have been caused by a bacterial infection. Most people should instead use pain relief drugs, which also include aspirin and ibuprofen, and certain throat lozenges, as well as drinking plenty of water and resting.

Prof Cliodna McNulty, head of PHE’s primary care unit, said: “Antibiotics are a precious resource and it’s important that they are only used when they are really needed.

“For a sore throat, evidence shows that antibiotics make little difference to length or severity of illness, unless symptoms are much more severe. While a sore throat can be painful, there are other ways to control the symptoms including taking paracetamol and medicated lozenges.”

NICE and PHE also said doctors should use set criteria to judge how likely it is that people have sore throats caused by bacterial infections. This works by checking people for scores across a range of symptoms, which include fever, pus on tonsils, severely inflamed tonsils and the absence of a cough.

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