From the Guidelines
For a viral sore throat, over-the-counter pain relievers like acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) can help reduce pain and inflammation, as recommended by the American College of Physicians and the Centers for Disease Control and Prevention 1.
Key Recommendations
- Adults can take acetaminophen 500-1000mg every 4-6 hours (not exceeding 4000mg daily) or ibuprofen 400-600mg every 6-8 hours with food.
- Throat lozenges containing benzocaine or menthol provide temporary numbing relief.
- Gargling with warm salt water (1/4 to 1/2 teaspoon of salt in 8 ounces of warm water) several times daily can soothe irritation.
- Staying hydrated with warm liquids like tea with honey helps moisturize the throat and thin mucus.
- A cool-mist humidifier can add moisture to dry air.
Important Considerations
- Antibiotics won't help viral infections, which typically resolve within 7-10 days, as stated in the guideline for the management of acute sore throat 1.
- If symptoms persist beyond 10 days, worsen suddenly, or include difficulty breathing or swallowing, seek medical attention.
- The Infectious Diseases Society of America recommends penicillin or amoxicillin for group A streptococcal pharyngitis, but this is not applicable for viral sore throat 1.
Quality of Life and Morbidity
- These remedies work by reducing inflammation, providing local anesthesia to nerve endings, or creating a protective coating on irritated throat tissues, ultimately improving quality of life and reducing morbidity.
- It is essential to note that the typical course of a sore throat is less than 1 week, and antibiotics are usually not needed because they do little to alleviate symptoms and may have adverse effects 1.
From the Research
Treatment Options for Viral Sore Throat
- Systemic analgesics such as acetylsalicylic acid, acetaminophen, flurbiprofen, or ibuprofen are valid treatment options for viral sore throat, 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
- Non-steroidal anti-inflammatory drugs (NSAIDs) and paracetamol can also be used to reduce symptoms of acute infective sore throat 3
Antibiotics for Sore Throat
- Antibiotics are not recommended for viral sore throat, as they are not effective against viral infections and can contribute to antimicrobial resistance 4, 5
- However, antibiotics may be prescribed for bacterial sore throat, with penicillin being the first choice and clarithromycin as an alternative for those who do not tolerate penicillin 4
- The use of antibiotics should be guided by clinical scores that assess the risk of bacterial pharyngitis, and delayed prescribing may be recommended for moderate-risk cases 4
Alternative Treatments
- A triple active sore throat lozenge containing tyrothricin, benzalkonium chloride, and benzocaine has been shown to be effective in relieving throat pain and difficulty in swallowing associated with acute pharyngitis 6
- This lozenge provides a rapid analgesic effect and is a suitable treatment option for patients in the self-management of acute pharyngitis and sore throat 6