What is the recommended treatment for viral pharyngitis?

From the Guidelines

The recommended treatment for viral pharyngitis is primarily supportive care, focusing on symptom relief with over-the-counter pain relievers, throat lozenges, and adequate hydration, as antibiotics are ineffective against viral infections. Treatment should include over-the-counter pain relievers such as acetaminophen (325-650 mg every 4-6 hours, not exceeding 3000 mg daily) or ibuprofen (400-600 mg every 6-8 hours with food) to help reduce pain, as suggested by 1. Throat lozenges, warm salt water gargles (1/4 to 1/2 teaspoon of salt in 8 ounces of warm water), and adequate hydration with warm liquids like tea with honey can help soothe throat discomfort. Rest is essential to allow the body to fight the infection. Most cases of viral pharyngitis resolve within 7-10 days without specific antiviral treatment. Some key points to consider in the management of viral pharyngitis include:

• The use of antibiotics is not recommended for viral pharyngitis, as they are ineffective against viral infections and may have adverse effects, as noted in 1 and 1.
• Patients can be assured that the typical course of a sore throat is less than 1 week and that antibiotics are usually not needed because they do little to alleviate symptoms, as stated in 1.
• If symptoms persist beyond 10 days, worsen after initial improvement, or are accompanied by high fever (above 101°F or 38.3°C for more than 3 days), difficulty breathing or swallowing, or severe pain, medical attention should be sought as these may indicate complications or a different diagnosis. Viral pharyngitis is self-limiting because the immune system naturally clears the infection, making symptomatic treatment the appropriate approach, as supported by the guidelines and evidence from 1 and 1.

From the Research

Treatment of Viral Pharyngitis

The treatment of viral pharyngitis primarily focuses on alleviating symptoms, as antibiotics are generally not effective against viral infections 2, 3, 4, 5, 6.

• Symptomatic Relief: Symptomatic treatment is the main approach for managing viral pharyngitis, including the use of analgesics and anti-inflammatory medications to reduce pain and inflammation.
• Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): NSAIDs such as flurbiprofen have been shown to provide rapid and long-lasting relief from sore throat symptoms 2.
• Corticosteroids: Short-acting oral corticosteroids like prednisone and dexamethasone can be effective in relieving pain and reducing the duration of symptoms in acute pharyngitis 3, 5.
• Local Anesthetics: Local anesthetics such as ambroxol, lidocaine, and benzocaine can provide effective pain relief for sore throats 4, 6.
• Systemic Analgesics: Systemic analgesics like acetylsalicylic acid, acetaminophen, ibuprofen, and flurbiprofen are valid treatment options for symptomatic relief in viral pharyngitis 6.

Recommendations

Based on the available evidence:

• Flurbiprofen spray can be recommended for rapid and long-lasting relief from sore throat symptoms 2.
• Single-dose dexamethasone can be considered as an adjuvant therapy for acute pharyngitis 3.
• Ambroxol lozenges are a safe and efficacious treatment for acute uncomplicated sore throat 4.
• Short-acting oral steroid therapy with prednisone can shorten the duration of throat pain in acute pharyngitis 5.
• Local anesthetics like ambroxol, lidocaine, and benzocaine, as well as systemic analgesics, are valid options for symptomatic treatment 6.