From the Guidelines
For dry cough and laryngitis, the most effective treatment approach is to focus on symptom relief and hydration, rather than antibiotics, as most cases are caused by viral infections. The use of antibiotics in treating acute laryngitis is unwarranted, as they are only effective in bacterial infections 1. Instead, patients can try over-the-counter options like dextromethorphan (15-30mg every 6-8 hours) for cough suppression or throat lozenges containing benzocaine or menthol.
Symptom Relief Measures
- Resting the voice as much as possible to allow vocal cord healing
- Using a humidifier or steam inhalation for 10-15 minutes several times daily to moisturize the throat
- Gargling with warm salt water (1/4 teaspoon salt in 8 ounces of water) several times daily to reduce inflammation
- Avoiding irritants like smoking, alcohol, and spicy foods
- Drinking plenty of warm fluids like water, tea with honey, or warm broth to stay hydrated
According to a study published in the journal Otolaryngology--head and neck surgery, acute laryngitis is self-limited, with most patients experiencing symptomatic improvement within 7 to 10 days irrespective of treatment 1. Another study published in the journal Thorax recommends a home remedy, such as honey and lemon, for treating coughs caused by viral infections 1.
When to Seek Medical Attention
If symptoms include fever over 101°F, difficulty breathing, cough lasting more than 2 weeks, or if you're coughing up blood or colored mucus, seek medical attention promptly. In some cases, antibiotics may be warranted, such as in patients with dysphonia secondary to bacterial infections or in immunosuppressed patients 1. However, the diagnosis should be established prior to initiation of therapy. A study published in the journal Chest recommends considering a trial of inhaled ipratropium or inhaled corticosteroids for adult patients with postinfectious cough 1.
From the FDA Drug Label
Purpose Cough suppressant
Package/Label Principal Display Panel Compare to Delsym® active ingredient Dextromethorphan Polistirex Extended-Release Oral Suspension Cough Suppressant
Dextromethorphan (PO) can be used to treat a dry cough as it is a cough suppressant 2 2.
- It may also help with laryngitis if the condition is associated with a dry cough, but there is no direct information in the label that supports its use specifically for laryngitis.
From the Research
Treatment Options for Dry Cough and Laryngitis
- Antitussive preparations, such as codeine or dextromethorphan, can be used to provide symptomatic relief for dry cough 3.
- First-generation antihistamines like chlorpheniramine and centrally acting opioid derivatives like codeine are often used alone or in combination to manage nonspecific cough 3.
- A diagnostic work-up for patients with persistent dry cough is necessary to identify the underlying cause, which may include post-viral cough, asthma, rhinosinusitis, or gastro-oesophageal reflux 4.
- Treatment with angiotensin-converting enzyme inhibitors can also lead to a persistent dry cough 4.
Efficacy of Specific Treatments
- Dextromethorphan has been shown to have limited efficacy in treating cough associated with acute upper respiratory tract infection 5.
- A combination of bilastine, dextromethorphan, and phenylephrine has been found to be non-inferior to a combination of chlorpheniramine, dextromethorphan, and phenylephrine in treating acute dry cough 6.
- Dextromethorphan premedication may have an additive effect on cough suppression during flexible bronchoscopy in adults 7.
Considerations for Treatment
- The most effective antitussive opiates can cause sedation and may be addictive 4.
- Non-sedating antihistamines like bilastine may be a preferred option for treating cough associated with a common cold or allergy 6.
- Further trials are needed to confirm the efficacy of certain treatments, such as dextromethorphan premedication, in specific contexts 7.