From the Guidelines
Laryngitis in adults should not be treated with antibiotics as a first-line treatment, unless there is a clear indication of a bacterial infection, as most cases are caused by acute viral laryngitis. The treatment options for laryngitis in adults focus on relieving symptoms and reducing inflammation.
Treatment Options
- Resting the voice as much as possible for 1-3 days
- Avoiding whispering, which can strain the vocal cords more than soft speech
- Drinking plenty of fluids, especially warm liquids like tea with honey, to soothe irritation and thin mucus
- Humidifying the environment to provide relief, particularly during sleep
- Using over-the-counter pain relievers such as acetaminophen (Tylenol) 500-1000mg every 6 hours or ibuprofen (Advil, Motrin) 400-600mg every 6-8 hours to reduce throat pain and inflammation
- Using throat lozenges containing benzocaine or menthol to temporarily relieve discomfort
- Avoiding irritants like smoking, secondhand smoke, alcohol, and spicy foods
When to Use Antibiotics
Antibiotics may be warranted in select circumstances, such as in immunosuppressed patients or in cases of bacterial laryngotracheitis secondary to Staphylococcus aureus, as stated in the clinical practice guideline 1. However, the routine use of antibiotics in treating patients with dysphonia is unwarranted, as they are effective only in bacterial infections, and most cases of dysphonia are caused by acute viral laryngitis 1.
Monitoring and Follow-up
Most cases of laryngitis resolve within 1-2 weeks with symptomatic treatment, and patients should see a doctor if symptoms persist beyond two weeks, or if they experience difficulty breathing or swallowing, cough up blood, or develop a fever over 101°F (38.3°C), as these may indicate a more serious condition requiring antibiotics or other treatments 1.
From the Research
Treatment Options for Laryngitis in Adults
- The treatment options for laryngitis in adults are limited, with most studies suggesting that antibiotics have no significant benefit in treating acute laryngitis 2, 3, 4.
- However, some studies suggest that erythromycin may reduce voice disturbance at one week and cough at two weeks when measured subjectively 2, 3, 4.
- Fusafungine, an antibiotic, may also increase the cure rate at day five 4.
- For chronic laryngitis, treatment may involve prolonged antibiotic therapy, and methicillin-resistant staphylococcus aureus (MRSA) may be a responsible pathogen 5.
- A study suggests that Sulfamethoxazole and trimethoprim may be effective in treating chronic bacterial laryngitis, particularly in cases where MRSA is present 5.
- Physical factors and comprehensive evaluation of clinical and functional characteristics may also be important in the treatment of exacerbations of chronic laryngitis in vocal professionals 6.
Antibiotic Therapy
- Penicillin V and erythromycin have been studied as potential treatments for acute laryngitis, but have shown no significant benefit in objective outcomes 2, 3, 4.
- Fusafungine and clarithromycin have also been studied, with some evidence suggesting that they may be beneficial in treating acute laryngitis 4.
- MRSA infection has been documented in 30% of patients with chronic bacterial laryngitis, and treatment with Sulfamethoxazole and trimethoprim may be effective in these cases 5.
Non-Antibiotic Treatment
- Physical factors, such as rest and hydration, may be important in the treatment of laryngitis 6.
- Comprehensive evaluation of clinical and functional characteristics, including voice scores and symptoms, may also be important in the treatment of exacerbations of chronic laryngitis in vocal professionals 6.