What is the treatment for acute sore throat with pain for 1 day?

From the Guidelines

For a sore throat that has been painful for one day, I recommend starting with over-the-counter pain relievers such as acetaminophen (Tylenol) 650mg every 6 hours or ibuprofen (Advil, Motrin) 400mg every 6-8 hours to reduce pain and inflammation. Gargling with warm salt water (1/2 teaspoon of salt in 8 ounces of warm water) several times daily can help reduce swelling and discomfort. Stay well-hydrated with warm liquids like tea with honey, which can soothe irritation. Throat lozenges containing benzocaine or menthol can provide temporary numbing relief. Rest your voice and avoid irritants like smoking or alcohol. Most viral sore throats resolve within 5-7 days with these measures.

Key Considerations

• If your sore throat is accompanied by fever over 101°F, persists beyond 3 days, or you have difficulty swallowing or breathing, you should seek medical attention as these could indicate strep throat or another bacterial infection requiring antibiotics 1.
• Bacterial infections typically cause more severe symptoms than viral ones and may need prescription treatment rather than just symptomatic relief.
• The use of antibiotics should be guided by the presence of specific symptoms suggestive of group A streptococcal pharyngitis, such as persistent fevers, anterior cervical adenitis, and tonsillopharyngeal exudates, and confirmed by rapid antigen detection test and/or culture for group A Streptococcus 1.

Treatment Approach

• For patients diagnosed with group A streptococcal infection, antibiotics can shorten the duration of sore throat by 1 to 2 days, but the benefit is modest and the number needed to treat to reduce symptoms is 6 after 3 days of treatment and 21 after 1 week of treatment 1.
• The European Society for Clinical Microbiology and Infectious Diseases recommends the use of either ibuprofen or paracetamol for relief of acute sore throat symptoms, and penicillin V for 10 days if antibiotics are indicated 1.

Monitoring and Follow-Up

• Patients should be monitored for signs of complications, such as acute rheumatic fever or acute glomerulonephritis, although these are rare in adults 1.
• If symptoms persist or worsen, patients should seek medical attention for further evaluation and treatment.

From the Research

Treatment Options for Acute Sore Throat

• Symptomatic treatment is recommended for acute sore throat, as the disease is usually self-limiting and of viral origin 2.
• Systemic analgesics such as acetylsalicylic acid, acetaminophen, flurbiprofen, or ibuprofen are valid treatment options, with ibuprofen showing the best benefit-risk profile 2.
• Local anesthetics like lidocain, benzocaine, and ambroxol can be recommended in the first-line treatment, with ambroxol having the best documented benefit-risk profile 2.

Use of Antibiotics

• Antibiotics are not recommended for acute sore throat unless there is a high risk of bacterial pharyngitis, as assessed by clinical scores such as Centor, McIsaac, or FeverPAIN 3.
• If antibiotics are considered, penicillin is the first choice, with clarithromycin as an alternative, and the treatment should be taken for 5-7 days 3.
• Antibiotics may reduce the incidence of suppurative and non-suppurative complications, but the absolute benefits are modest, and the number of patients needed to treat to prevent one complication is high 4, 5.

Specific Antibiotic Therapy

• For bacterial acute sore throat, penicillin V has been shown to have a strong and constant bactericidal activity, without risk of selection or appearance of resistant strains, and is considered the reference treatment 6.
• Macrolides and tetracyclines may have lower efficacy due to resistance, and cephalosporins may introduce risks of modification of the oro-pharyngeal ecology 6.