What's the best protocol to manage a potential common viral infection with initial symptoms of a sore throat that has shown some improvement?

Best Protocol for Early Viral Upper Respiratory Infection

For a sore throat that improved overnight, no treatment beyond symptomatic relief is needed—antibiotics are not indicated, and the illness will resolve on its own within 7-10 days. 1

Immediate Management Strategy

Symptomatic treatment only is the appropriate approach for what appears to be a common cold or viral pharyngitis:

• Use ibuprofen or acetaminophen (paracetamol) for pain relief, as these are the recommended first-line agents for acute sore throat symptoms 1, 2
• Ibuprofen provides slightly more effective pain relief than acetaminophen for throat discomfort 2
• Do not use antibiotics, as they provide no benefit for viral infections and cause more harm than good (number needed to harm = 8 vs number needed to benefit = 18) 1

Why Antibiotics Are Not Indicated

The fact that your symptoms improved overnight strongly suggests viral pharyngitis, which:

• Resolves spontaneously within 7-10 days regardless of treatment 1, 3
• Accounts for the vast majority of sore throat cases 1
• Does not respond to antibiotics at all 1
• Antibiotics only shorten symptom duration by approximately 8 hours overall in bacterial cases, while exposing you to unnecessary side effects 4

Additional Supportive Measures

Consider these evidence-based symptomatic treatments:

• Combination antihistamine-decongestant-analgesic products provide significant symptom relief in 1 out of 4 patients 1
• Saline nasal irrigation for nasal congestion 1
• Adequate hydration and rest 1
• Handwashing is the most effective prevention method to avoid spreading the virus 1

When to Seek Medical Attention

Return for evaluation if you develop any red flag symptoms indicating serious complications:

• Difficulty swallowing, drooling, or neck swelling (suggests peritonsillar or retropharyngeal abscess) 5, 6
• Severe unilateral throat pain with inability to open mouth (trismus) 5, 6
• Stridor, respiratory distress, or sitting-forward position (suggests epiglottitis—an airway emergency) 5, 2
• Symptoms persisting beyond 2 weeks without improvement 2, 3
• Worsening symptoms after initial improvement, or high fever (>39°C) with severe symptoms 1

Common Pitfalls to Avoid

• Do not seek antibiotics "just in case"—this contributes to antibiotic resistance and exposes you to unnecessary side effects without benefit 1
• Do not use zinc gluconate, herbal treatments, or acupuncture, as evidence for these is inconsistent or insufficient 1, 2
• Expect symptoms to last up to 2 weeks—this is normal for viral infections and does not indicate need for antibiotics 1, 3

The Bottom Line

Since your sore throat already improved overnight, this confirms a self-limited viral process. Continue symptomatic treatment with ibuprofen or acetaminophen as needed, stay hydrated, and expect complete resolution within 7-10 days. No testing or antibiotics are warranted unless red flag symptoms develop. 1, 2