From the Guidelines
Laryngitis treatment should focus on rest, hydration, and symptom management, rather than antibiotics, as most cases are caused by acute viral infections and resolve naturally within 7 to 10 days 1. The primary approach to managing laryngitis involves:
- Resting the voice completely for 1-3 days to reduce strain on the vocal cords
- Staying hydrated by drinking plenty of fluids, at least 8-10 glasses of water daily, to keep the throat moist
- Using a humidifier or breathing steam from a hot shower to add moisture to the air
- Taking over-the-counter medications like acetaminophen (325-650mg every 4-6 hours) or ibuprofen (200-400mg every 4-6 hours) for pain relief
- Using throat lozenges containing benzocaine or menthol to temporarily numb the throat
- Gargling with warm salt water (1/4 to 1/2 teaspoon in 8 ounces of water) several times daily to reduce inflammation
- Avoiding irritants like smoking, alcohol, and spicy foods Antibiotics should only be considered in select circumstances, such as in immunosuppressed patients or when there is a confirmed bacterial infection 1. It is essential to note that misuse of antibiotics can lead to unnecessary costs, side effects, and contribute to antibiotic resistance, which can have serious health and cost impacts 1. If symptoms persist beyond two weeks, are severe, or include difficulty breathing or swallowing, medical attention should be sought to rule out underlying conditions that may require antibiotics or other treatments 1.
From the Research
Treatment Options for Laryngitis
- The treatment for laryngitis depends on the type and severity of the condition, with options including:
- Emergency administration of systemic and inhaled glucocorticoids in the hospital setting for glotto-subglottic laryngitis, with a high dosage of more than 0.3 mg/kg dexamethasone for 48 hours, followed by oral corticosteroids 2
- Antibiotics in combination with corticosteroids for epiglottitis (supraglottic laryngitis) and subglottic laryngitis 2
- Conservative management, which may include rest, hydration, and voice therapy, for acute laryngitis 3
- Nebulizer therapy with antiedematous, steroid, and mucolytic drugs for acute laryngeal inflammation 4
Effectiveness of Antibiotics
- Research suggests that antibiotics may not be effective in treating acute laryngitis, with one study finding no significant differences in objective voice scores between participants who received penicillin V and those who received a placebo 5
- Another study found that erythromycin may reduce voice disturbance at one week and cough at two weeks when measured subjectively, but this outcome is not considered relevant in clinical practice 5
Comprehensive Evaluation and Treatment
- A comprehensive and uniform evaluation of the results of treatment for vocal professionals experiencing exacerbations of chronic laryngitis is proposed, including a system of quantitative gradation of main clinical and functional characteristics and an aggregate health index 6
- This approach can be employed by otorhinolaryngologists, phoniatrists, physiatrists, and developers of new technologies for the treatment of exacerbations of chronic laryngitis 6