Acute Pharyngitis — MRCGP AKT MCQ

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EasyENTAcute PharyngitisMRCGP AKT UKMLA PARA

A 21-year-old adult presents with an uncomplicated acute sore throat. Their FeverPAIN score is 1 and there are no red-flag features or risk factors for serious illness. What is the most appropriate management?

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Correct answer: C — Do not prescribe antibiotics; give analgesia and safety-netting advice

A FeverPAIN score of 0 or 1 identifies an adult who is unlikely to benefit from antibiotics. NICE advises no antibiotic prescription, symptomatic treatment (for example paracetamol or, if suitable, ibuprofen), fluids and clear safety-netting. Advise review if symptoms worsen rapidly or significantly, the person becomes systemically very unwell, or symptoms do not start to improve after 1 week. Immediate phenoxymethylpenicillin and a back-up antibiotic are not indicated at this score; co-amoxiclav is not a routine first-choice agent for uncomplicated sore throat. Routine throat swabbing does not justify immediate macrolide treatment. Corticosteroids are not recommended routinely for uncomplicated acute sore throat.

Reference: NICE. Sore throat (acute): antimicrobial prescribing (NG84), recommendations 1.1.4–1.1.7 and self-care recommendations. 2018. https://www.nice.org.uk/guidance/NG84/chapter/recommendations