From the Guidelines
Acute laryngitis treatment should primarily focus on voice rest and supportive care, avoiding the use of steroids and antibiotics unless absolutely necessary, as evidenced by the lack of supporting data for their efficacy in treating dysphonia and the potential for significant side effects 1. The treatment approach for acute laryngitis should prioritize measures to reduce inflammation and promote healing of the vocal cords.
- Rest your voice as much as possible for 3-7 days, avoiding whispering which can strain vocal cords more than soft speech.
- Stay hydrated by drinking 8-10 glasses of water daily to keep vocal cord mucosa moist.
- Use a humidifier or breathe steam from a hot shower to reduce inflammation.
- For pain relief, take acetaminophen (Tylenol) 500-1000mg every 6 hours or ibuprofen (Advil, Motrin) 400-600mg every 6-8 hours as needed.
- Throat lozenges containing benzocaine or menthol can provide temporary comfort.
- Avoid alcohol, caffeine, and smoking which irritate the larynx. Most cases of acute laryngitis resolve within 1-2 weeks without antibiotics, as it is typically a viral infection 1.
- Only seek medical attention if you experience difficulty breathing, cough up blood, have high fever (>101°F), symptoms lasting beyond two weeks, or if you're a professional voice user needing expedited care. Antibiotics are rarely needed unless a bacterial infection is confirmed by your healthcare provider, and their misuse can lead to unnecessary costs, side effects, and contribute to antibiotic resistance 1.
From the Research
Treatment Options for Acute Laryngitis
- The effectiveness of antibiotic therapies in treating acute laryngitis has been assessed in several studies 2, 3, 4, 5.
- These studies found that antibiotics appear to have no benefit in treating acute laryngitis when assessing objective outcomes 2, 3, 4, 5.
- However, some antibiotics, such as erythromycin, may reduce voice disturbance at one week and cough at two weeks when measured subjectively 2, 3, 4, 5.
- Fusafungine, an antibiotic, may also increase the cure rate at day five 5.
Diagnosis and Management
- A thorough history is the most important step toward developing a differential diagnosis for laryngitis 6.
- Treatment of specific pathologies depends on the causative pathogen or etiology, as well as the age, vocal demands, and clinical characteristics of the individual 6.
- Vocal pathologies often have a noticeable impact on a person's quality of life and daily activities, and patients should be counseled on the course of the disease process 6.
Antibiotic Use
- The use of antibiotics in treating acute laryngitis is not recommended as a first-line treatment due to the lack of objective benefits and the potential for adverse effects and antibiotic resistance 2, 3, 4, 5.
- The decision to use antibiotics should be based on a thorough evaluation of the patient's condition and the potential benefits and risks of treatment 2, 3, 4, 5.