What can relieve throat discomfort?

Effective Treatments for Throat Discomfort

Ibuprofen or paracetamol are the most effective first-line treatments for relieving throat discomfort and should be used as the primary approach for symptom relief. 1, 2

First-Line Systemic Analgesics

• Ibuprofen (400mg for adults) provides superior pain relief compared to paracetamol for sore throat symptoms, particularly after the first 2 hours of treatment 3
• Both ibuprofen and paracetamol are effective for reducing acute sore throat symptoms with strong evidence supporting their use 2
• For children, both medications have comparable safety profiles, but ibuprofen (5-10 mg/kg) demonstrates better fever reduction than paracetamol (10-15 mg/kg) 4, 5
• The European Society of Clinical Microbiology and Infectious Diseases specifically recommends ibuprofen as the preferred option if there are no contraindications 1

Topical Treatments (Second-Line)

• Local anesthetic sprays containing phenol (1.4%) can provide temporary relief of minor throat irritation and pain 6
• Lozenges containing local anesthetics such as lidocaine (8mg), benzocaine (8mg), or ambroxol (20mg) can be recommended as adjunctive therapy for additional symptom relief 7
• Flurbiprofen 8.75mg lozenges have demonstrated effectiveness for relieving sore throat pain, difficulty swallowing, and the sensation of a swollen throat 8

Treatment Algorithm

1. Start with systemic analgesics:

   • Ibuprofen (400mg for adults, 5-10mg/kg for children) every 6-8 hours as needed 1, 2
   • Paracetamol (1000mg for adults, 10-15mg/kg for children) every 4-6 hours as needed if ibuprofen is contraindicated 1, 2

2. Add topical treatments if needed:

   • Local anesthetic sprays (containing phenol) 6, 7
   • Lozenges with local anesthetics or anti-inflammatory properties 7, 8

Important Considerations and Pitfalls

• Local antibiotics or antiseptics should not be used for sore throat treatment due to the mainly viral origin of most sore throats and lack of efficacy data 7
• Corticosteroids are not routinely recommended for sore throat treatment in self-care settings but may be considered in conjunction with antibiotic therapy for adults with severe presentations under medical supervision 1, 2
• Zinc gluconate is not recommended for sore throat treatment due to conflicting efficacy results and increased adverse effects 1
• There is inconsistent evidence supporting herbal treatments and acupuncture as treatments for sore throat 1, 2
• For persistent symptoms lasting more than 7 days or accompanied by high fever, difficulty breathing, or severe pain, medical evaluation is recommended 1

Special Populations

• For children under 2 years, ibuprofen has been shown to provide better fever reduction and pain relief compared to paracetamol with equivalent safety profiles 5
• In pregnant women, paracetamol is generally preferred over NSAIDs, especially in the third trimester 2
• For patients with gastrointestinal conditions or renal impairment, paracetamol may be preferred over ibuprofen 2