From the Guidelines
Laryngitis treatment should primarily focus on rest, hydration, and symptom management, without the routine use of antibiotics or corticosteroids, as most cases are viral and resolve within 1-2 weeks with conservative measures. The treatment approach should prioritize reducing symptoms and preventing complications, rather than relying on antibiotics or steroids, which have limited efficacy and potential side effects 1.
Key Components of Treatment
- Rest your voice completely for 1-3 days, avoiding whispering which can strain vocal cords further
- Stay well-hydrated by drinking 8-10 glasses of water daily to keep the throat moist
- Use a humidifier or breathe steam from a hot shower to reduce irritation
- For pain relief, take acetaminophen (Tylenol) 500-1000mg every 6 hours or ibuprofen (Advil, Motrin) 400-600mg every 6-8 hours as needed
- Throat lozenges containing benzocaine or menthol can provide temporary relief
- Gargling with warm salt water (1/4 teaspoon salt in 8 ounces water) several times daily helps reduce inflammation
- Avoid irritants like smoking, alcohol, and spicy foods
When to Seek Medical Attention
If symptoms persist beyond two weeks, include difficulty breathing, coughing up blood, or high fever (above 103°F), seek medical attention as antibiotics may be needed for bacterial infections or other treatments for underlying conditions 1. Antibiotics may be appropriate in select circumstances, such as in immunosuppressed patients or those with bacterial infections like pertussis or laryngotracheitis 1.
Avoiding Unnecessary Treatments
The routine use of antibiotics for laryngitis is not recommended, as it can lead to unnecessary costs, side effects, and contribute to antibiotic resistance 1. Similarly, the use of corticosteroids should be avoided, except in special circumstances, due to the potential for significant and serious side effects, including insomnia, gastrointestinal disturbances, and increased risk of fractures and cardiovascular events 1.
From the Research
Treatment Options for Laryngitis
- The effectiveness of antibiotics in treating acute laryngitis is debated, with some studies suggesting they have no benefit in improving objective symptoms 2, 3, 4.
- However, certain antibiotics such as erythromycin may have some subjective benefits, such as reducing voice disturbance at one week and cough at two weeks 2, 3, 4.
- Another study found that fusafungine could increase the cure rate at day five, but the quality of the evidence was very low 2.
- For chronic laryngitis, the treatment approach may involve addressing the underlying causes, such as infectious, inflammatory, or autoimmune factors 5.
- It is essential to note that laryngitis can be caused by various factors, including irritants, toxins, antigens, mechanical effects, and infectious agents, and treatment should be tailored to the specific cause 6.
Key Findings
- Antibiotics may not be effective in treating acute laryngitis, and their use should be carefully considered due to the risk of adverse effects and antibiotic resistance 2, 3, 4.
- The quality of evidence for the effectiveness of antibiotics in treating laryngitis is generally low, highlighting the need for further research 2.
- Chronic laryngitis requires a comprehensive treatment approach that addresses the underlying causes and symptoms 5.