From the Guidelines
Treatment for acute viral laryngitis primarily involves supportive care, as antibiotics are ineffective against viral infections, and the most recent evidence from 1 supports this approach. The goal is to manage symptoms and prevent complications, focusing on morbidity, mortality, and quality of life.
Supportive Care Measures
- Rest your voice as much as possible and avoid whispering, which can strain vocal cords more than soft speech.
- Stay hydrated by drinking plenty of fluids, especially warm liquids like tea with honey, which can soothe irritated throat tissues.
- Use a humidifier or breathe steam from a hot shower to moisturize the airways.
- For pain relief, over-the-counter medications like acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) can be taken as directed.
Cough Suppression
- For cough suppression, dextromethorphan (found in Robitussin DM, Delsym) can be effective at recommended doses, typically 10-30 mg every 4-8 hours for adults, as suggested by 1 and 1.
- Throat lozenges containing benzocaine or menthol may provide temporary relief.
Avoiding Irritants
- Avoid irritants like smoking, secondhand smoke, and alcohol.
Monitoring and Seeking Medical Attention
- Most cases resolve within 1-2 weeks with these measures.
- If symptoms persist beyond two weeks, worsen significantly, or if you develop difficulty breathing or swallowing, seek medical attention as these could indicate a more serious condition requiring different treatment, emphasizing the importance of monitoring as per 1.
By following these guidelines, patients can effectively manage the symptoms of acute viral laryngitis and cough, prioritizing their morbidity, mortality, and quality of life.
From the FDA Drug Label
Stop use and ask doctor if cough persists for more than 7 days, tends to recur, or is accompanied by fever, rash, or persistent headache. These could be signs of a serious condition. Purpose Cough suppressant Antihistamine The treatment for acute viral laryngitis and cough suppression may include the use of a cough suppressant such as dextromethorphan (PO) 2 2.
- The patient should be advised to stop use and ask a doctor if the cough persists for more than 7 days, tends to recur, or is accompanied by fever, rash, or persistent headache.
- Dextromethorphan (PO) can be used as a cough suppressant to help relieve cough symptoms.
From the Research
Treatment for Acute Viral Laryngitis
- The treatment for acute viral laryngitis primarily focuses on relieving symptoms, as there is no direct link between acute and chronic inflammation of the larynx 3.
- Emergency administration of systemic and inhaled glucocorticoids in the hospital setting is the basic treatment for glotto-subglottic laryngitis, with a high dosage of more than 0.3 mg/kg dexamethasone for 48 hours, followed by oral corticosteroids 3.
- For children with acute laryngitis, systemic glucocorticoid combined with inhaled steroid has been shown to be effective in relieving symptoms, although it has similar efficacy to single systemic glucocorticoid 4.
Cough Suppression
- There is no significant evidence to support the use of antibiotics in treating acute laryngitis, as they do not objectively improve symptoms 5, 6.
- Erythromycin may reduce voice disturbance at one week and cough at two weeks when measured subjectively, but this is not considered relevant in clinical practice 6.
- Treatment of chronic cough due to postviral vagal neuropathy has focused on the use of neuromodulators, although diagnosis requires a thorough history and physical exam 7.
Management
- Diagnosis of viral laryngitis requires a thorough history and physical exam, and in certain cases, referral to other subspecialties such as gastroenterology and pulmonology 7.
- Treatment of laryngeal shingles and idiopathic ulcerative laryngitis has not been well defined due to the rarity of these conditions, although recent studies have explored potential future treatment options 7.