From the Guidelines
Treatment for allergic pharyngitis should start with intranasal corticosteroids, such as fluticasone (1-2 sprays per nostril daily) or mometasone (2 sprays per nostril daily), as they are the most effective medication class for controlling symptoms, as recommended by the 2017 Joint Task Force on Practice Parameters 1. For initial treatment of seasonal allergic rhinitis in persons aged 12 years or older, monotherapy with an intranasal corticosteroid is recommended over an intranasal corticosteroid in combination with an oral antihistamine, according to the 2017 guideline from the Joint Task Force on Practice Parameters 1. Some key points to consider when treating allergic pharyngitis include:
- Using antihistamines like cetirizine (10mg daily), loratadine (10mg daily), or fexofenadine (180mg daily) to block histamine receptors and reduce throat inflammation, as suggested by the 2008 practice parameter 1.
- Considering the combination of an intranasal corticosteroid and an intranasal antihistamine for initial treatment of moderate to severe seasonal allergic rhinitis, as recommended by the 2017 Joint Task Force on Practice Parameters 1.
- Avoiding the use of antibiotics, as allergic pharyngitis is caused by an immune response to environmental allergens rather than pathogens, as noted in the example answer.
- Identifying and avoiding triggering allergens, staying hydrated, and using throat lozenges containing benzocaine or menthol for temporary pain relief, as suggested in the example answer. It is essential to consult a healthcare provider if symptoms persist beyond 7-10 days or worsen despite these measures, as stronger medications or further evaluation may be necessary to rule out other conditions, as noted in the example answer.
From the Research
Allergic Pharyngitis Treatment
- The treatment of allergic pharyngitis is closely related to the treatment of allergic rhinitis, as both conditions often present with similar symptoms such as nasal congestion, sneezing, and itching of the eyes, nose, and throat 2.
- First-line treatment for mild intermittent or mild persistent allergic rhinitis may include a second-generation H1 antihistamine (eg, cetirizine, fexofenadine, desloratadine, loratadine) or an intranasal antihistamine (eg, azelastine, olopatadine) 2.
- Patients with persistent moderate to severe allergic rhinitis should be treated initially with an intranasal corticosteroid (eg, fluticasone, triamcinolone, budesonide, mometasone) either alone or in combination with an intranasal antihistamine 2.
- H1-antihistamines and intranasal steroids are commonly used pharmacological agents for the treatment of allergic rhinitis, with H1-antihistamines blocking both neural and vascular H1 receptors and having a clinical effect on symptoms such as nasal itching, sneezing, and rhinorrhea 3.
- Second-generation H1 antihistamines in oral and intranasal formulations, including in combination with intranasal corticosteroids, have been shown to be safe and effective in adult and pediatric allergic rhinitis populations 4.
Differences from Acute Pharyngitis
- Acute pharyngitis in adults is one of the most common infectious diseases seen in general practitioners' consultations, with viral aetiology being the most common and Streptococcus pyogenes or group A β-haemolytic streptococcus (GABHS) being the main bacterial cause 5.
- The treatment of acute pharyngitis is focused on speeding up symptom resolution, reducing the contagious time span, and preventing local suppurative and non-suppurative complications, with penicillin and amoxicillin being the antibiotics of choice for the treatment of pharyngitis 5.
- The treatment of allergic pharyngitis is distinct from the treatment of acute pharyngitis, with a focus on managing allergic symptoms and preventing future episodes rather than treating an infectious cause 2, 6, 3, 4.