Antibiotics for Sore Throat: 5 Types & When To Take

Updated in November 2022

Some antibiotics, like amoxicillin, azithromycin and cephalexin, can help to treat a sore throat. With the right treatment, symptoms like burning, fever, headache and difficulty swallowing can be relieved. 

Throat inflammation may be caused by a viral or bacterial infection, which are commonly transmitted from person-to-person through direct contact of contaminated surface or through exposure to droplets in the air. These types of infections often lead to tonsillitis or pharyngitis. 

In most cases, a sore throat resolves on its own within 3 to 5 days without any antibiotic treatments. They may be prescribed with specific conditions, however, to prevent further health complications. 

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When are antibiotics recommended? 

Treatment for a sore throat is generally indicated for a bacterial infection, such as bacterial pharyngitis and bacterial tonsillitis. To confirm the presence of bacteria, the doctor may perform a throat swab to collect a specimen from the throat. If the swab is positive for bacteria and the patient remains symptomatic, the doctor may opt to start antibiotics. 

A swab to confirm a diagnosis may not always be possible as these specimen require time for processing. time-sensitive, To determine whether starting antibiotics immediately is needed, the doctor may assess for a patient’s risk for bacterial pharyngitis. Many factors are considered for this risk assessment such as the presence of tonsil lesions, swollen lymph nodes, the patient’s age, and the patient’s other symptoms, including fever.

A low risk for a bacterial infection does not require antibiotics, while a higher risk may lead the doctor to delay prescription until results are back or an immediate prescription. 

5 antibiotics for sore throat 

The most commonly prescribed antibiotics for the treatment of sore throat include:

1. Amoxicillin

Amoxicillin is generally indicated for the treatment of infections caused by Streptococcus A. bacteria, like pharyngitis and tonsillitis. 

Dosing and duration time will vary depending on the patient’s health stats, age and body weight. However, for adults and children over 40 kg (or about 90 lb) is between 250 to 1000 mg, 3 times per day. 

Contraindications: Amoxicillin is not recommended for patients with an allergy to amoxicillin, penicillin and cephalosporins. Women who are pregnant or breastfeeding, and patients with a history of kidney disease should also discuss alternatives with their doctor. 

Possible side effects: Using amoxicillin may cause some side effects, like diarrhea, vomiting, redness and itching. Although there is no studies that show that amoxicillin interferes with birth control, reactions like diarrhea or vomiting may decrease effectiveness. Therefore, other contraceptive methods (like condoms) are recommended during treatment. 

2. Azithromycin

Azithromycin is an antibiotic that is prescribed in pill or syrup form. It is indicated for throat inflammation caused by a bacteria infection, like tonsillitis or pharyngitis. It may also be prescribed for the treatment of viral infections, like mononucleosis. This is an infection caused by the Epstein-Barr virus that is associated with symptoms like fever, sore throat and throat swelling. 

Dosing and treatment duration depends on the patient’s age and presenting illness. Therefore, the doctor may prescribe between 250 to 1000 mg per day for adults. Pediatric doses should be calculated based on the child’s age and weight.

Contraindications: Azithromycin should not be used by patients who are allergic to this medication or to erythromycin. It is also not recommended for use by patients with a history of liver, kidney or heart disease.

Pregnant or breastfeeding women should only use azithromycin as guided by an obstetrician. 

Possible side effects: Azithromycin can cause nausea, headaches, drowsiness, vomiting, diarrhea, constipation, loss of appetite or excess gas. 

3. Erythromycin

Erythromycin can interfere with bacterial growth, making it a great option for treating respiratory infections and throat inflammation. 

This antibiotic can be prescribed in pill, capsule or liquid form, and should generally be taken in intervals of 6 to 12 hours, 2 to 4 times per day. Dosing depends on the patient’s health status, weight and age, therefore it is essential to consult a doctor before starting this medication. 

Contraindications: This medication is not advised for patients with an allergy to erythromycin and azithromycin. People who use other medications should report them to their doctor, as they may interfere with the effect of erythromycin. In addition, patients with a history of arrhythmia or liver disease, as well as pregnant or breastfeeding women, should discuss this medication with the doctor before starting it.

Possible side effects: The most common side effects are diarrhea, vomiting, stomach pain and loss of appetite. Azithromycin can cause severe allergic reactions, like anaphylaxis, which may lead to symptoms like difficulty breathing, mouth swelling and facial swelling. 

4. Clindamycin

Clindamycin is indicated for the treatment of bacterial throat infections, like tonsillitis, pharyngitis or laryngitis. It works by impeding bacterial growth..

This medication can be found in capsule form. The recommended dose for adults is 600 to 1800 mg per day, divided into 2 to 4 equal doses. For children, dosing and frequency depends on weight. 

Contraindications: This medication should not be used by patients with a clindamycin or lincomycin allergy. Women who are breastfeeding or pregnant, and patients with a history of liver disease, kidney disease, stomach issues or intestinal problems should report these to their doctor before starting treatment. Clindamycin is not indicated for people with meningitis. Some medications may interfere with this antibiotic’s effects, therefore you should report all medication that you take to your doctor before starting.

Possible side effects: Clindamycin can cause some side effects like nausea, vomiting, bitter taste, joint pain, nausea and white spots in the mouth. This medication can also cause a severe allergic reaction with symptoms like hives, difficulty swallowing, throat swelling, and lips or tongue swelling. In these cases, you should seek medical attention immediately.

5. Cephalexin

Cephalexin is an antibiotic that kills bacteria and prevents further bacterial growth. It may be prescribed for throat inflammation caused by bacteria, like pharyngitis. 

This antibiotic may be found in capsule, pill or syrup form. It is often taken in intervals of 6 to 12 hours for 7 to 14 days. Dosing and treatment duration depends on the patient’s age and health status. 

Contraindications: Patients with allergies to antibiotics should report these to the prescriber before starting this medication. Pregnant or breastfeeding women, as well as patients with a history of seizures, stomach problems, esophageal disease, intestinal issues, kidney disease or liver disease should also report their health history to the doctor.

Possible side effects: Side effects may include nausea, diarrhea, vomiting, nausea, stomach pain, agitation, dizziness and fatigue. You should seek immediate medical attention if you have severe symptoms, like bloody stools, fever during or after treatment, skin irritation or itching, difficulty breathing or swallowing and hallucinations.