From the Research
Treatment for infectious mononucleosis primarily involves supportive care, with patients advised to get adequate rest, stay hydrated, and take over-the-counter pain relievers like acetaminophen or ibuprofen to manage fever and sore throat. According to the most recent and highest quality study 1, infectious mononucleosis is a self-limited disease that typically resolves on its own within 2-4 weeks. Patients should be advised to:
- Get adequate rest and stay hydrated
- Take over-the-counter pain relievers like acetaminophen (500-1000 mg every 6 hours, not exceeding 4000 mg daily) or ibuprofen (400-600 mg every 6-8 hours with food) to manage fever and sore throat
- Gargle with warm salt water (1/2 teaspoon salt in 8 oz warm water) several times daily to relieve throat discomfort
- Avoid contact sports and strenuous physical activity for at least 3-4 weeks to prevent splenic rupture, as the spleen often enlarges during mono
- Avoid alcohol completely while recovering and for several months afterward due to the risk of liver inflammation In severe cases with significant tonsillar swelling causing airway obstruction, a short course of corticosteroids like prednisone (40-60 mg daily for 5-7 days with tapering) may be prescribed, as suggested by previous studies 2, 3, 4. However, the use of corticosteroids should be reserved for severe cases, as their effectiveness for symptom control in infectious mononucleosis is still uncertain. Antibiotics are not effective against mono since it's caused by the Epstein-Barr virus, but may be needed if a secondary bacterial infection develops. Most patients recover completely with these measures, though fatigue may persist for several weeks to months after other symptoms resolve.