Dealing with Sore Throats and tonsil infection in Children

Introduction:

Sore throats are a common woe for children, often causing discomfort and worry for parents. Here, we offer practical guidelines to help parents navigate through this common childhood ailment.

What is sore throat?

The term 'sore throat' describes the symptom of pain at the back of the mouth. This includes:

• Acute pharyngitis: inflammation of the part of the throat behind the soft palate (oropharynx).
• Tonsillitis: inflammation of the tonsils.

Acute throat infections most commonly occur in people aged 5–24 years.

What casues sore throat?

Acute sore throat is usually caused by a viral or bacterial infection. Non-infectious causes are uncommon and include physical irritation from gastro-oesophageal reflux disease or chronic cigarette smoke, and hayfever, however pleae remember these are uncommon!

Common causes of sore throat in primary care are usually not life-threatening and include common cold, influenza, streptococcal infection, and infectious mononucleosis.

Recognising Symptoms:

When your child complains of a sore throat, it's essential to observe for other symptoms, such as fever, cough, and swollen glands. These can provide clues about the cause of the sore throat, helping parents decide when medical attention may be necessary.

Most causes of sore thorat are self limiting:

Sore throat due to a viral or bacterial cause is a self-limiting condition. Symptoms resolve within 3 days in 40% of people, and within 1 week in 85% of people, irrespective of whether or not the sore throat is due to a streptococcal infection.

Home Remedies:

• symptoms can last for around 1 week, but most people will get better within this time without antibiotics, regardless of cause (bacteria or virus)
• NICE encourages parents to try simple remedies at home first. Encourage your child to drink plenty of fluids, and provide age-appropriate over-the-counter pain relief if needed. It's crucial to ensure your child gets enough rest during this time.
• Be aware that no evidence is found on  lozenges, mouthwashes, or local anaesthetic mouth spray used on its own in children. Some adults may wish to try medicated lozenges containing either a local anaesthetic, a non-steroidal anti-inflammatory drug (NSAID) or an antiseptic. However, they may only help to reduce pain by a small amount.

When to Seek Medical Advice:

• While most sore throats get better with time and home care, seek medical advice if your child has difficulty breathing, harsh seal-like barking cough, drooling, dehydration, persistent high fever more than 5 days, symptoms are worsening after 3-5 days, your child becomes unwell  or if the sore throat lasts for more than a week. 
• Seek medical input for children with recurrent tonsillitis (a frequency of more than 7 episodes per year for one year, 5 per year for 2 years, or 3 per year for 3 years) as they may benefit from tonsillectomy (surgical removal of tonsils).

Antibiotics and Testing:

NICE advises against routinely prescribing antibiotics for sore throats, as they are often self limited.  Antibiotics are only recommended if your child is unwell or symptoms are worsening significantly or rapidly  after assessment by your healthcare provider.  

In some cases, your health provider may choose a middle path and prescribe delayed (back up) antibiotics taking account of:

• evidence that antibiotics make little difference to how long symptoms last (on average, they shorten symptoms by about 16 hours)
• evidence that most people feel better after 1 week, with or without antibiotics
• the unlikely event of complications if antibiotics are withheld
• possible adverse effects, particularly diarrhoea and nausea.

Preventing the Spread of Infections:

Teach your child good hygiene practices to prevent the spread of infections. Encourage regular handwashing, covering the mouth and nose when coughing or sneezing, and avoiding close contact with others when unwell. This can help reduce the risk of recurrent sore throats.

Conclusion:

In most cases, sore throats in children are a passing discomfort that can be managed effectively at home. Following these guidelines provides a structured approach to understanding when to try home remedies and when to seek professional medical advice. By being informed and proactive, parents can help their children recover from sore throats with minimal stress and inconvenience.