A sore throat can feel scratchy, dry or painful, especially when you swallow. Most are caused by a virus and clear up on their own within a week or so, but some need a doctor's assessment or antibiotics. This page explains the likely causes, the warning signs and when to see a doctor.

Emergency

Call triple zero (000) or go to your nearest emergency department if you have a sore throat and:

• you have difficulty breathing, or noisy, high-pitched breathing (stridor)
• you are drooling or cannot swallow your own saliva
• you have severe pain on one side of your throat with a muffled "hot potato" voice or trouble opening your mouth (this can be a collection of pus next to the tonsil, called quinsy or a peritonsillar abscess)
• you cannot swallow enough fluids to stay hydrated
• you have significant swelling in the front or side of your neck
• you have a stiff neck with a high fever (this can, rarely, be a deep infection of the neck or nervous system)
• you have a high fever that does not come down with paracetamol or ibuprofen
• you are bleeding from your mouth or throat after recent tonsil surgery
• you feel extremely unwell, very drowsy or confused

Key points

• Most sore throats are caused by a virus and get better on their own within about a week to ten days.
• A smaller number are caused by bacteria, usually group A streptococcus (strep throat), and may need antibiotics.
• Doctors use a scoring tool (the Centor criteria) to judge how likely a bacterial cause is.
• Antibiotics do not work against viruses, so a careful assessment helps you avoid antibiotics you do not need.
• Untreated strep throat can rarely lead to serious complications, including rheumatic fever, particularly in some Aboriginal and Torres Strait Islander communities.
• A Doccy consultation can help with medical certificates, antibiotics if they are needed, and a referral to an ear, nose and throat (ENT) surgeon if you keep getting tonsillitis.

What is a sore throat?

A sore throat is pain, dryness, scratchiness or a burning feeling at the back of your throat, often worse when you swallow. Doctors call it pharyngitis, which means inflammation of the pharynx (the part of your throat behind your mouth and nose). Your voice may sound different, and your tonsils (the two lumps of tissue at the back of the throat) may look red, swollen or have white spots.

A sore throat is a symptom, not a diagnosis. Most are caused by a cold or flu virus and clear up on their own. Some are caused by bacteria and need antibiotics. A small number need urgent care and assessment.

When to see a doctor

If you have any of the signs in the emergency box at the top of this page, call triple zero (000) or go to your nearest emergency department.

Get an urgent GP appointment, or call healthdirect on 1800 022 222 for advice, if:

• you have a very high temperature, or you feel hot, cold or shivery
• your pain is getting worse despite pain relief, or is much worse on one side of your throat
• you have signs of dehydration, such as peeing less than usual or dark, strong-smelling pee
• you have a weakened immune system, for example during chemotherapy or because of a medicine your doctor has told you can lower your white blood cells (if you are having chemotherapy, contact your treating team straight away)
• you are worried about your symptoms

See a GP if:

• your sore throat has not improved after a week
• you have a fever, white spots on your tonsils and swollen glands in your neck but no cough, which can be a sign of strep throat
• you often get sore throats or keep getting tonsillitis
• your sore throat or hoarse voice lasts more than 3 weeks, or you notice a lump in your neck or mouth, a mouth ulcer that does not heal, pain in one ear, or food sticking when you swallow, especially if you smoke or drink alcohol

A GP can examine your throat and neck, use a scoring tool to judge how likely a bacterial infection is, and arrange a throat swab if needed. This helps decide whether you need antibiotics or just time and self-care.

Common causes of a sore throat

Viral pharyngitis is the most common cause. Cold and flu viruses, and other common respiratory viruses including COVID-19, make the lining of the throat red and inflamed. It usually comes with a runny nose, cough, mild fever and sometimes red or watery eyes. Symptoms usually peak within 3 to 5 days and settle by around day 10.

Tonsillitis is inflammation of the tonsils. It often causes pain that is worse on swallowing and can spread to the ears, with fever, swollen glands in the neck (lymph nodes) and spots on the tonsils. It can be caused by a virus or bacteria. If your doctor thinks group A streptococcus is the cause, they may prescribe antibiotics. If pain and swelling stop you swallowing fluids or medicines, you may need a short hospital stay for treatment through a drip. Read more in our article on whether tonsillitis is contagious.

Glandular fever (infectious mononucleosis) is caused by the Epstein-Barr virus and can look like tonsillitis. It is more common in teenagers and young adults. It causes fever, swollen glands in the neck, tiredness and sometimes spots on the tonsils. The sore throat usually eases within 2 to 3 weeks, but the tiredness can last for weeks to months. Glandular fever can also enlarge your spleen (an organ on the left side of your abdomen). Your doctor will advise you to avoid contact sports, heavy lifting and strenuous exercise for a while, because of the rare but serious risk of the spleen rupturing.

Non-infectious causes include reflux, where stomach acid moves back up the food pipe and irritates the throat (often worse in the morning), and postnasal drip, where mucus from the nose or sinuses runs down the back of the throat. This can be caused by allergies, hay fever or sinus infections. Dry air from heating or air conditioning, and smoking (including vaping), can also irritate the throat.

This is not a full list. Your age, other health conditions and risk factors all affect which causes are more likely.

Do I need antibiotics or a throat swab?

Most sore throats are caused by viruses, and antibiotics do not work against viruses. Taking them when they are not needed will not help you get better, and it adds to antibiotic resistance, where bacteria adapt so antibiotics stop working when they are needed.

To judge how likely a bacterial infection is, doctors often use a scoring tool called the Centor criteria (or the McIsaac score, which also takes age into account). It gives points for a fever, tender swollen glands at the front of the neck, white spots or pus on the tonsils, and abscence of cough. A low score supports a "wait and see" approach. A higher score means a doctor may consider a swab or antibiotics. The score is a guide, not a certainty, so doctors combine it with your history and how unwell you are.

A large Cochrane review found antibiotics shorten a sore throat only slightly for most people. Their clearest benefit is preventing rare complications such as rheumatic fever in people at higher risk. This is why a doctor may recommend pain relief and time rather than a prescription.

A throat swab is most useful when the result would change what happens next. Doctors are more likely to swab and treat with antibiotics for Aboriginal and Torres Strait Islander people, especially in regional and remote communities, and for anyone who has had rheumatic fever or rheumatic heart disease. A lab swab takes a day or two, while a rapid test gives a result in minutes but can miss some infections. If a rapid test is negative but your doctor still suspects strep throat, they may send a lab swab as well.

Self-care for a sore throat

These tips are for mild sore throats only. If you have any of the signs in the emergency box, get help straight away.

• Drink plenty of fluids, such as water, herbal tea or warm soup.
• Gargle with warm, salty water a few times a day.
• Take paracetamol or ibuprofen if needed for pain and fever. Ask your pharmacist which is right for you, and follow the directions on the packet.
• Suck on lozenges or ice chips to ease pain when swallowing.
• Rest your voice. Try not to shout, sing or talk for long periods.
• Avoid smoke and vaping, and try a humidifier or a steamy bathroom if dry air makes things worse.

Outlook

Most sore throats get better within a week to ten days without treatment. Complications are uncommon, but include a collection of pus next to the tonsil (quinsy) and, rarely after strep throat, rheumatic fever, which can damage the heart. If you keep getting tonsillitis, an ENT surgeon can talk to you about whether removing your tonsils (tonsillectomy) would help.

How Doccy doctors can help

A Doccy consultation can help if you have a mild sore throat, or you have had tonsillitis before and recognise the signs, and none of the warning signs on this page. The doctor may ask you to send a photo of the back of your throat. A Doccy consultation can:

• provide a medical certificate if you need time off work or study, or a carer's certificate if you are looking after someone who is unwell
• provide a special consideration letter if a sore throat or tonsillitis has affected a university assessment or deadline
• prescribe antibiotics if a bacterial infection is likely and they are appropriate for you
• refer you to an ENT surgeon if you keep getting tonsillitis (for example, 4 or more episodes in a year, or 6 or more in 2 years) and you would consider having your tonsils removed

A Doccy consultation is not suitable if you have any of the signs in the emergency box. A photo cannot replace a full examination, so a sore throat that is getting worse needs to be seen in person.

Resources and support

healthdirect: information on sore throat and strep throat, and a 24-hour nurse advice line on 1800 022 222.

Australian Commission on Safety and Quality in Health Care: consumer information on whether a sore throat needs antibiotics.

RHD Australia: information on acute rheumatic fever and rheumatic heart disease, particularly for Aboriginal and Torres Strait Islander communities.

Your local Aboriginal Community Controlled Health Organisation (ACCHO): culturally safe care and rheumatic fever prevention programs.

These services and websites can provide extra information, but they do not replace advice from your own doctor.

1. healthdirect. Sore throat (pharyngitis). 2025. https://www.healthdirect.gov.au/sore-throat
2. Australian Commission on Safety and Quality in Health Care. Sore throat: should I take antibiotics? 2023. https://www.safetyandquality.gov.au/publications-and-resources/resource-library/sore-throat-should-i-take-antibiotics
3. Rheumatic Heart Disease Australia. Australian guideline for prevention, diagnosis and management of acute rheumatic fever and rheumatic heart disease. 2025. https://www.rhdaustralia.org.au/wp-content/uploads/2025/08/Australian-ARF-RHD-Guideline-2025_August.pdf
4. Kanagasabai A, Evans C, Jones HE, et al. Systematic review and meta-analysis of the accuracy of McIsaac and Centor score in patients presenting to secondary care with pharyngitis. Clin Microbiol Infect. 2024;30(4):445-452. https://pubmed.ncbi.nlm.nih.gov/38182052/
5. Spinks A, Glasziou PP, Del Mar CB. Antibiotics for treatment of sore throat in children and adults. Cochrane Database Syst Rev. 2021;12:CD000023. https://pubmed.ncbi.nlm.nih.gov/34881426/
6. Cancer Australia. Head and neck cancer: symptoms and diagnosis. 2025. https://www.canceraustralia.gov.au/cancer-types/head-and-neck-cancer/symptoms-and-diagnosis
7. healthdirect. Tonsillitis. 2025. https://www.healthdirect.gov.au/tonsillitis