What are the suggested over-the-counter (OTC) and home treatments for college students with acute pharyngitis, nasal congestion, and fatigue?

OTC and Home Treatments for College Students with Short-Duration Sore Throat, Nasal Congestion, and Fatigue

For college students experiencing 1-2 days of sore throat, nasal congestion, and fatigue, the recommended treatment is symptomatic relief with analgesics, nasal saline irrigation, adequate hydration, and rest, as these symptoms typically indicate a viral infection that will resolve within 7 days without antibiotics. 1

Understanding the Condition

• These symptoms lasting 1-2 days most likely represent a viral upper respiratory tract infection, which is self-limiting and does not require antibiotics 1
• Viral rhinosinusitis and pharyngitis typically resolve within one week without specific treatment 1
• Less than 35% of sore throats are caused by bacterial infections, with most being viral in origin 2

First-Line Symptomatic Treatments

For Sore Throat

• Analgesic therapy including acetaminophen, ibuprofen, or other nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce pain and fever 1
• Throat lozenges can help provide localized pain relief 1
• Salt water gargles can offer topical pain relief, though clinical data on efficacy are limited 1

For Nasal Congestion

• Nasal saline irrigation helps relieve congestion, remove secretions, and moisturize nasal passages 1, 3
• Oral decongestants containing pseudoephedrine can temporarily relieve sinus congestion and pressure, unless contraindicated (e.g., hypertension, anxiety) 1, 4
• Topical nasal decongestants may provide quick relief but should not be used for more than 3-5 days to avoid rebound congestion (rhinitis medicamentosa) 1

For General Symptoms

• Adequate hydration helps thin mucus secretions 3
• Proper rest promotes recovery 3
• Humidification of the environment can relieve mucosal dryness 3

Medication Selection Guidelines

Recommended OTC Options

• For pain/fever: Ibuprofen or naproxen are preferred for anti-inflammatory and analgesic effects 3, 2
• For congestion: Pseudoephedrine-containing products provide effective decongestant action 1, 4
• For multiple symptoms: First-generation antihistamine/decongestant combinations containing sustained-release pseudoephedrine may help with both congestion and other symptoms 3

Medications to Avoid or Use with Caution

• Newer generation non-sedating antihistamines are relatively ineffective for common cold symptoms 3
• Antibiotics should not be used as they are ineffective for viral illnesses and contribute to antibiotic resistance 1, 3

When to Seek Further Medical Evaluation

• If symptoms persist beyond 7 days without improvement 1
• If symptoms worsen after initial improvement ("double sickening") 1
• If severe symptoms develop (fever >39°C, purulent nasal discharge, or facial pain lasting >3 consecutive days) 1
• If signs suggestive of group A streptococcal pharyngitis appear (persistent fever, anterior cervical adenitis, tonsillopharyngeal exudates) 1

Common Pitfalls to Avoid

• Assuming colored nasal discharge (yellow/green) indicates bacterial infection—this actually reflects neutrophil presence, not bacteria 1
• Using topical nasal decongestants for more than 3-5 days, which can lead to rebound congestion 1
• Requesting antibiotics for viral infections, which provides no benefit and increases risk of adverse effects 1, 3
• Neglecting adequate hydration and rest, which are fundamental to recovery 3