Sore throats are common: and penicillin therapy should be rare

Children often have bad sore throats. It's the most common reason why they are taken to the family doctor. And in his or her turn, the doctor will usually prescribe a seven-day course of penicillin.

It's been considered 'best practice' for years, but a new study says that doing nothing is just as good as penicillin, and possibly less harmful. Penicillin should be reserved for those 15 per cent of cases of sore throat caused by streptococcal infection, the researchers say.

They tested penicillin against placebo (a sugar pill) on a group of 156 children who had a sore throat for less than seven days. The duration of the sore throat and the school days lost was the same in both groups - in other words, penicillin had no effect. Interestingly, those children in the placebo group whose sore throat was caused by streptococcal infection also fared as well as their counterparts in the penicillin group, so it could even be argued that doing nothing is just as good as penicillin even for treating infectious sore throats. Its sole benefit seems to be in preventing the sore throat worsening to quinsy, impetigo or scarlet fever.

(Source: British Medical Journal, 2003; 327: 1324-7).