What is the recommended treatment for throat pain?

Treatment Recommendations for Throat Pain

For throat pain, the primary treatment is symptomatic relief with analgesics such as ibuprofen (400mg every 6-8 hours) or paracetamol/acetaminophen (500-1000mg every 4-6 hours), with ibuprofen showing superior efficacy for pain relief. 1

First-Line Treatment Options

Systemic Analgesics

• Ibuprofen:

  • Adults: 400mg every 6-8 hours (maximum 1200mg/day)
  • Children: 5-10mg/kg every 6-8 hours
  • Shows best benefit-risk profile among analgesics 1, 2
  • Provides 47% reduction in sore throat pain over first 24 hours 3

• Paracetamol/Acetaminophen:

  • Adults: 500-1000mg every 4-6 hours (maximum 4000mg/day)
  • Children: 10-15mg/kg every 4-6 hours
  • Less effective than ibuprofen but still superior to placebo 4

• Important caution: Aspirin should be avoided in children due to risk of Reye syndrome 1

Topical Treatments

• Local anesthetics with confirmed efficacy:

  • Lidocaine (8mg)
  • Benzocaine (8mg)
  • Ambroxol (20mg) - best documented benefit-risk profile 2
  • Phenol-containing products for temporary relief of minor throat pain 5

• Lozenges containing flurbiprofen 8.75mg:

  • Can provide relief for pain intensity, difficulty swallowing, and throat swelling 3
  • Can be taken up to five times daily (every 3-6 hours)

Treatment Algorithm

1. Assess severity and duration of symptoms:

   • If severe throat pain with high fever, headache, nausea, or vomiting, refer to physician immediately 5
   • If mild to moderate pain without concerning symptoms, proceed with symptomatic treatment

2. First-line treatment:

   • Begin with systemic analgesics (ibuprofen preferred over acetaminophen)
   • Consider adding topical anesthetics for additional relief

3. For persistent symptoms:

   • If symptoms persist beyond 2 days without improvement, medical evaluation is recommended 5
   • Assess for possible bacterial infection using Centor criteria 1

Special Considerations

• Duration of treatment: Do not use topical treatments for more than 2 days without medical consultation 5

• Bacterial vs. viral etiology:

  • Most sore throats are viral and self-limiting 6
  • Antibiotics should only be considered for confirmed streptococcal infections 1

• Supportive measures:

  • Maintain adequate hydration 1
  • Avoid sharing utensils or drinks 1

Common Pitfalls to Avoid

• Overuse of antibiotics: Throat infections are predominantly viral; antibiotics should be reserved for confirmed bacterial infections 6

• Inadequate pain control: Pain from throat inflammation can be severe and requires appropriate dosing of analgesics 7

• Delayed medical attention: Severe or persistent sore throat with fever, headache, nausea, or vomiting requires prompt medical evaluation 5

• Using aspirin in children: This increases risk of Reye syndrome 1

• Relying solely on topical treatments: Systemic analgesics provide more comprehensive relief and should be the foundation of treatment 1, 2