What medication is recommended for a sore throat?

From the Guidelines

For a sore throat, over-the-counter pain relievers like acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) are recommended to reduce pain and inflammation, as antibiotics are only necessary for bacterial infections like strep throat, which can be diagnosed using the Centor clinical scoring system or rapid antigen test 1.

Recommended Medications

• Acetaminophen 325-650mg every 4-6 hours (not exceeding 3000mg daily)
• Ibuprofen 200-400mg every 4-6 hours with food (not exceeding 1200mg daily)

Additional Relief Measures

• Throat lozenges containing benzocaine or menthol for temporary numbing relief
• Gargling with warm salt water (1/4 to 1/2 teaspoon of salt in 8 ounces of warm water) several times daily to reduce swelling and discomfort
• Staying hydrated with warm liquids like tea with honey to soothe irritation

Antibiotic Use

• Antibiotics should only be used in patients with a high likelihood of streptococcal infections (e.g. 3–4 Centor criteria) 1
• Penicillin V, twice or three times daily for 10 days, is recommended as the first choice antibiotic 1
• Cephalexin can be used as a second-line antibiotic due to its lower rate of relapse, good tolerability, and narrow spectrum 1

From the FDA Drug Label

Principal Display Panel Compare to Chloraseptic® active ingredient* Sore Throat Spray Phenol 1.4% Oral Anesthetic / Analgesic Spray Relieves sore throat The recommended medication for a sore throat is Phenol 1.4% Oral Anesthetic / Analgesic Spray 2.

• Key benefits: Relieves sore throat, Aspirin free, Sugar Free
• Age restriction: For ages 2 years and older

From the Research

Medication for Sore Throat

• The medication recommended for a sore throat depends on the cause of the infection. For bacterial infections such as streptococcal pharyngitis, antibiotics are prescribed 3, 4, 5.
• Penicillin and amoxicillin are first-line antibiotics for treating streptococcal pharyngitis, with a recommended course of 10 days 3, 5.
• For patients with nonanaphylactic allergies to penicillin, first-generation cephalosporins are recommended 3.
• Steroids are not recommended for symptomatic treatment of sore throat 3.
• Over-the-counter analgesics and antipyretics can be used to provide symptom relief for sore throat, regardless of the cause 6.
• For viral infections, treatment is focused on relieving symptoms, and antibiotics are not effective 4, 6.

Antibiotic Treatment

• Antibiotics can reduce the duration and severity of sore throat symptoms, as well as the risk of complications such as acute otitis media and quinsy 4.
• However, the use of antibiotics must be balanced against the risk of antimicrobial resistance, and clinicians must judge on an individual basis whether antibiotic treatment is justified 4.
• The decision to prescribe antibiotics should be based on a careful physical examination, patient history, and diagnostic testing, such as rapid antigen detection tests or throat culture 3, 5, 7.

Alternative Treatments

• For children, alternative treatments such as honey (for children one year and older), nasal saline irrigation, and topical application of ointment containing camphor, menthol, and eucalyptus oils may be effective in relieving sore throat symptoms 6.
• Zinc and Lactobacillus casei may also be beneficial in reducing the duration and severity of cold symptoms, including sore throat 6.