Acute sore throat is a common presentation in primary care settings. We aimed to 
improve our compliance with national antibiotic guidelines for sore throat 
symptoms to 90% in 3 months' time period. The national guidelines are based on 
Centor criteria. A retrospective audit of 102 patient records with sore throat 
symptoms presenting between 1 January to 30 December 2015 showed that over 50% 
were given antibiotics. Those who were prescribed antibiotics, 27% did not meet 
NICE criteria and 85% of patients were given immediate antibiotic prescription. 
Centor criteria was documented in just 2% of cases. Compliance with correct 
antibiotic course length was 15%. Antibiotic choice and dose was correct in 94% 
and 92% of cases respectively. Antibiotic frequency was correctly prescribed in 
100% of patients. We introduced interventions that included oral and poster 
presentations to multidisciplinary team, dissemination of guidelines through 
internal e-mail and systemic changes to GP electronic patient record system 
EMIS. This involved creating an automated sore throat template and information 
page. On re-auditing of 71 patients, after two PDSA cycles, compliance with NICE 
criteria was 87% with a significant reduction in immediate prescribing (66%). 
Centor criteria documentation was 42%. Correct antibiotic course length was 
prescribed in over 30% of cases. Other antibiotic regimen parameters (choice, 
dose and frequency) were correct in 100% of cases. The initial results 
demonstrated that significant changes were needed. In particular, reducing the 
amount of antibiotics prescribed by increasing compliance with NICE criteria and 
ensuring all parameters of antibiotic prescription were correct. We showed that 
significant sustainable improvement is achievable through carefully devised 
automated systemic changes that provides critical information in readily 
accessible format, and does not solely rely on prescribers' knowledge and 
initiative. The outcome of these interventions are a decrease in immediate 
antibiotic prescription, significant increase in Centor criteria documentation 
and an increase in compliance with the correct course length of antibiotics. All 
these measures would contribute to reduction in antimicrobial resistance and 
improvement in patient care in the community. Future work must focus on 
improving compliance with correct antibiotic course length.