Acute Pharyngitis — MRCGP AKT MCQ

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EasyInfectious DiseasesAcute PharyngitisMRCGP AKT UKMLA PARA

A 22-year-old student presents with a 2-day history of sore throat. Their Centor score is 2. They are otherwise well, are not systemically very unwell, and have no symptoms or signs suggesting a suppurative complication. What is the most appropriate management strategy?

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Correct answer: C — Give self-care and safety-netting advice without antibiotics

The correct answer is C. NICE advises that people with a Centor score of 0, 1 or 2 are unlikely to benefit from antibiotics and should be offered self-care and safety-netting rather than an antibiotic prescription. Discuss analgesia or antipyretics as appropriate, fluid intake, the expected course of about 1 week, and review if symptoms worsen rapidly or significantly, fail to improve after 1 week, or systemic illness develops. Immediate phenoxymethylpenicillin is not indicated at this score; if an antibiotic is required, it is first-line rather than co-amoxiclav. A back-up prescription is not recommended solely on the basis of a Centor score of 2. Routine throat swabbing is unnecessary in uncomplicated acute sore throat and should not delay initial advice.

Reference: NICE. Sore throat (acute): antimicrobial prescribing (NG84), recommendations 1.1.3–1.1.7. 2018, updated information November 2025. https://www.nice.org.uk/guidance/NG84/chapter/recommendations