The European Society for Clinical Microbiology and Infectious Diseases 
established the Sore Throat Guideline Group to write an updated guideline to 
diagnose and treat patients with acute sore throat. In diagnosis, Centor 
clinical scoring system or rapid antigen test can be helpful in targeting 
antibiotic use. The Centor scoring system can help to identify those patients 
who have higher likelihood of group A streptococcal infection. In patients with 
high likelihood of streptococcal infections (e.g. 3-4 Centor criteria) 
physicians can consider the use of rapid antigen test (RAT). If RAT is 
performed, throat culture is not necessary after a negative RAT for the 
diagnosis of group A streptococci. To treat sore throat, either ibuprofen or 
paracetamol are recommended for relief of acute sore throat symptoms. Zinc 
gluconate is not recommended to be used in sore throat. There is inconsistent 
evidence of herbal treatments and acupuncture as treatments for sore throat. 
Antibiotics should not be used in patients with less severe presentation of sore 
throat, e.g. 0-2 Centor criteria to relieve symptoms. Modest benefits of 
antibiotics, which have been observed in patients with 3-4 Centor criteria, have 
to be weighed against side effects, the effect of antibiotics on microbiota, 
increased antibacterial resistance, medicalisation and costs. The prevention of 
suppurative complications is not a specific indication for antibiotic therapy in 
sore throat. If antibiotics are indicated, penicillin V, twice or three times 
daily for 10 days is recommended. At the present, there is no evidence enough 
that indicates shorter treatment length.