This is a sample prescription sent by a patient who went to a doctor for a sore throat treatment.

He developed flu, sore throat and fever two days back. The fever was documented as a 101 F, with chills and body aches. prescription for a sore throat.

Sore throat treatment prescription details ...

The patient was prescribed the following medicines:

1. Softin-P: This tablet contains loratadine and pseudoephedrine
2. Panadol: contains paracetamol or acetaminophen
3. Betnesol: contains betamethasone
4. Zetro: contains azithromycin

Let's analyze the above prescription

General observations:

1. The name of the doctor and the patient were written over the prescription. For moral reasons, part of the prescription where the name of the doctor and the patient were written has been hidden. The date was mentioned.
2. Diagnosis of the patient or any symptoms and signs for which the medicines were prescribed is not mentioned over the prescription.
3. The strength of the tablets is also not mentioned except for zetro. However, since softin-p, panadol and betnesol are available in single strengths, in such cases, mentioning the dose may not be mandatory.
4. Duration of the treatment is not mentioned.
5. Signature of the doctor is there at the end of the prescription but a valid stamp of the doctor is not visible. Since the signature may not be a valid one, the doctor should stamp his prescription.

Sore throat treatment - Prescription analysis:

The above prescription contains:

1. an antiallergic medicine and a decongestant (softin-P)
2. fever medicine (panadol)
3. a glucocorticoid- betamethasone (betnesol)
4. antibiotic azithromycin - a macrolide (zetro)

So, before commenting on the list of medications prescribed by the doctor, I would like to briefly comment on the diagnosis of the patient.

Symptoms of fever, flu, sore throat and body aches and pains are pointing to a diagnosis of an upper respiratory tract infection, likely acute pharyngitis.

Acute pharyngitis is inflammation of the mucosa of the back of the throat behind the nose.

Most cases of acute pharyngitis (up to 80%) are caused by viruses. Bacterial infections especially Group A streptococcus can also cause pharyngitis in some patients.

Patients who have bacterial pharyngitis usually have a high-grade fever, severe symptoms like difficulty in swallowing, and a prolonged illness.

The final words ... the main theme of the "Prescription Checker"

Since your main queries are:

1. Should I take all the medicines prescribed by my doctor?

2. For how long should I take them?

3. What side-effects I may experience with my medicines?

4. When Should I feel better after I start taking these medicines?

5. What if my symptoms get worse and I don't feel better?

Let's discuss your queries one by one ... Should you be taking all the medicines prescribed by your doctor?

In my opinion, NO.

I will strongly advise you not to take the steroids (Betnesol - betamethasone).

Steroids are not recommended for viral or bacterial pharyngitis except in cases of severe pharyngitis causing airway obstruction.

Furthermore, the steroid dose prescribed by your doctor is thrice daily of betamethasone.

Even in severe pharyngitis, a single dose of steroids may be used. Steroids are potent anti-inflammatory drugs and therefore they may rapidly improve the symptoms.

However, complications of pharyngitis like peritonsillar abscesses and other complications like diabetes, hypertension and reduced immunity are the worrisome complications of these drugs.

Apart from steroids, you can use azithromycin (zetro) if your doctor suspects a bacterial cause.

However, alternative antibiotics like amoxicillin and amoxicillin-clavulanic acid may be suitable alternative choices.

Softin-P and panadol are for symptomatic relief and can be used.

The next question is "For how long the medicines should be continued?"

Softin-P and panadol may be used as long as you have fever and flu, since these are for symptomatic relief.

Zetro (Azithromycin) is recommended for three to five days.

A single dose of steroids (betnesol) may be given in severe cases.

What side-effects you may experience with these medicines?

Softin-P tablets may cause drowsiness, lethargy, dry mouth, nose and oral cavity, increased heartbeats (palpitations), fluctuations in blood pressure, irregular heartbeats, urinary retention, and nervousness.

Zetro (azithromycin) may cause nausea, distaste, diarrhea and abdominal pain.

Betnesol (Betamethasone) is a steroid and has a long list of side effects. It reduces immunity and makes a person prone to infections.

Steroids may cause psychiatric problems, muscle weakness, makes bone fragile and leads to osteoporosis, leads to fluid and salt retention causing heart failure and hypertension and increase blood glucose leading to diabetes.

When should you feel better after starting your medicines?

The fever, flu and sore throat should start getting better within the first twelve hours. However, resolution of the infection may take up to three days.

What if my symptoms get worse or I don't feel better with the medicines?

You should promptly visit your doctor or a hospital if you develop difficulty in swallowing or breathing.

The reasons your symptoms might get worse may include:

1. Resistant bacteria not responding to the azithromycin or zetro.
2. Development of complications like peritonsillar and para-pharyngeal abscesses.

I hope most of the questions related to your prescription have been answered. If you have further queries, you are most welcome to ask.

How often do you prescribe steroids for the treatment of sore throat?