Symptomatic treatment of acute pharyngitis in adults
- Wendy Stead, MD
Wendy Stead, MD
- Assistant Professor of Medicine
- Harvard Medical School
Acute pharyngitis is one of the most common conditions treated in office practice, with millions of visits annually in the United States  and millions more patients reaching out for treatment advice.
This topic will address options for the symptomatic relief of throat pain in adults with acute pharyngitis of viral (the most common cause of infectious sore throat in adults) or bacterial etiology.
The evaluation of the adult patient with acute pharyngitis, the antibiotic treatment of streptococcal tonsillopharyngitis, the diagnosis and treatment of season influenza, and issues specific to pharyngitis due to mononucleosis are discussed separately. (See "Evaluation of acute pharyngitis in adults" and "Treatment and prevention of streptococcal tonsillopharyngitis" and "Diagnosis of seasonal influenza in adults" and "Treatment of seasonal influenza in adults" and "Clinical manifestations and treatment of Epstein-Barr virus infection".)
The evaluation and treatment of less common but serious causes of sore throat including epiglottitis, peritonsillar abscess, submandibular and retropharyngeal space infections, and acute human immunodeficiency virus (HIV) infection, are discussed separately. (See "Evaluation of acute pharyngitis in adults", section on 'Excluding dangerous conditions' and "Evaluation of acute pharyngitis in adults", section on 'Non-infectious causes' and "Epiglottitis (supraglottitis): Clinical features and diagnosis" and "Epiglottitis (supraglottitis): Management" and "Peritonsillar cellulitis and abscess" and "Deep neck space infections" and "Acute and early HIV infection: Clinical manifestations and diagnosis".)
Most adult patients with acute pharyngitis have a viral illness for which they are seeking relief of sore throat pain, which is important for patient comfort and improves the patient’s ability to remain appropriately hydrated. A discussion of options for pain relief should accompany the evaluation for the etiology of the throat pain, which is most likely to be a self-limiting virus, less likely a bacterium requiring antibiotics (eg, Streptococcus or gonococcus) , and much less likely, a very serious infection (eg, epiglottitis, peritonsillar abscess, deep space infections, or acute human immunodeficiency virus [HIV]).
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- GENERAL CONCEPTS
- Approach to symptom control
- Avoid antibiotic overprescribing
- SYSTEMIC ORAL THERAPIES
- Choosing an oral analgesic
- - NSAID efficacy
- - Aspirin efficacy
- - Acetaminophen efficacy
- Limited role of glucocorticoids
- THERAPIES APPLIED TOPICALLY TO THE THROAT
- Throat sprays
- Fluids, herbs, and foods for sore throat relief
- HELPFUL ENVIRONMENTAL APPROACHES
- THERAPIES OF UNCERTAIN BENEFIT
- SOCIETY GUIDELINE LINKS
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS