From the Guidelines
Laryngitis treatment should primarily focus on rest, hydration, and symptom management, without the routine use of antibiotics, as most cases are caused by acute viral laryngitis and resolve within 7 to 10 days irrespective of treatment. The treatment approach for laryngitis involves several key components:
- Resting the voice as much as possible, avoiding whispering, which can strain vocal cords more than soft speech 1.
- Drinking plenty of fluids, especially warm liquids like tea with honey, to soothe irritation and thin mucus.
- Using a humidifier or breathing steam from a shower to add moisture to the environment.
- Over-the-counter pain relievers like acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) can reduce pain and inflammation; it is essential to follow package dosing instructions.
- Avoiding irritants such as smoking, secondhand smoke, and alcohol.
- For symptom relief, trying throat lozenges or gargling with warm salt water (1/4 to 1/2 teaspoon salt in 8 ounces of water). Most cases of laryngitis resolve within 1-2 weeks with these measures. It is crucial to see a doctor if symptoms persist beyond two weeks, if there is difficulty breathing, coughing up blood, severe pain, high fever, or trouble swallowing. Antibiotics may be warranted in select circumstances, such as in immunosuppressed patients or when a bacterial infection is confirmed, but their routine empiric use in treating patients with dysphonia is unwarranted due to the risk of promoting antibiotic resistance and other adverse effects 1.
From the Research
Treatment Options for Laryngitis
- The effectiveness of antibiotic therapies in treating acute laryngitis in adults has been assessed in several studies 2, 3, 4, 5.
- These studies found that antibiotics appear to have no benefit in treating acute laryngitis when assessing objective outcomes, such as objective voice scores 2, 3, 4, 5.
- However, some antibiotics, such as erythromycin, may be beneficial for some subjective outcomes, such as reducing voice disturbance at one week and cough at two weeks 2, 3, 4, 5.
- Another study found that fusafungine, an antibiotic, could increase the cure rate at day five when used to treat acute laryngitis 5.
Causes and Types of Laryngitis
- Laryngitis can be caused by inflammatory processes that affect the unified airway, including direct effects of irritants, toxins, and antigens, as well as mechanical and infectious effects 6.
- Laryngeal inflammation can also be secondary to behavioral mechanisms, such as vocal abuse or misuse 6.
- There are different types of laryngitis, including acute and chronic laryngitis, each with its own pathophysiologic mechanisms and treatment options 6.
Implications for Practice
- The implications for practice are that prescribing antibiotics should not be done in the first instance as they will not objectively improve symptoms 2, 3, 4, 5.
- Treatment for laryngitis should focus on controlling symptoms and addressing the underlying causes of the condition, rather than relying solely on antibiotic therapy 2, 3, 4, 5, 6.