What are the recommended at-home remedies for a non-severe sore throat in an otherwise healthy patient?

At-Home Sore Throat Remedies

For a non-severe sore throat in an otherwise healthy patient, ibuprofen or paracetamol (acetaminophen) are the recommended first-line treatments, with ibuprofen showing slightly better efficacy for pain relief. 1, 2, 3

First-Line Symptomatic Treatment

• Ibuprofen is the preferred systemic analgesic for acute sore throat, with evidence showing better pain relief particularly after 2 hours of administration compared to paracetamol 3, 4
• Paracetamol (acetaminophen) is an equally effective alternative with strong evidence supporting its use for short-term treatment 1, 2, 3
• Both medications have a low risk of adverse effects when used according to directions for short-term use 3

Additional Home Remedies with Evidence

• Honey and lemon can be considered as a home remedy if the patient desires treatment 1
• Menthol lozenges or vapor may provide symptomatic relief 1
• Local anesthetics (lidocaine 8mg, benzocaine 8mg, or ambroxol 20mg lozenges) have confirmed efficiency in clinical trials and can be recommended for first-line treatment, with ambroxol having the best documented benefit-risk profile 4

What NOT to Recommend

• Zinc gluconate should NOT be used for sore throat treatment due to conflicting efficacy results and increased adverse effects 1, 2, 3
• Herbal treatments and acupuncture have inconsistent evidence and should not be recommended 1, 2, 3
• Local antibiotics or antiseptics should NOT be recommended due to the mainly viral origin of sore throats and lack of efficacy data 3, 4
• Antibiotics are NOT indicated for patients with less severe presentations (0-2 Centor criteria) and do not relieve symptoms in these cases 1, 2

When to Seek Medical Attention

Patients should see a doctor if they experience: 1

• Coughing up blood
• Breathlessness
• Prolonged fever and feeling unwell
• Pre-existing medical conditions (chronic bronchitis/COPD, heart disease, diabetes, asthma)
• Recent hospitalization
• Symptoms persisting for more than three weeks

Key Clinical Pitfalls

• Most sore throats are viral and self-limiting, with a mean duration of 7 days 5
• Antibiotics do NOT prevent suppurative complications (quinsy, otitis media, sinusitis, mastoiditis) in most cases 1, 2
• Antibiotics do NOT prevent rheumatic fever or glomerulonephritis in low-risk patients without prior rheumatic fever history 1, 2
• Even when bacterial infection is present, antibiotics provide only modest symptom relief that must be weighed against side effects, antimicrobial resistance, and costs 1, 2