From the Guidelines
Laryngitis that improves with amoxicillin is typically caused by bacterial infections, such as those caused by Streptococcus pneumoniae, Haemophilus influenzae, or Group A Streptococcus, which may require antibiotic treatment. According to the clinical practice guideline on hoarseness (dysphonia) updated in 2018 1, antibiotics, including amoxicillin, are effective only in bacterial infections, and their routine empiric use in treating patients with dysphonia is unwarranted. However, in select circumstances, such as in immunosuppressed patients or those with bacterial infections like pertussis or bacterial laryngotracheitis, antibiotics may be appropriate.
The diagnosis of bacterial laryngitis should be established prior to initiation of therapy, and patients should be treated with amoxicillin at a dosage of 500 mg three times daily for adults (or 45 mg/kg/day divided into three doses for children) for 7-10 days, as this is a common treatment regimen for bacterial infections. Patients should complete the entire course of antibiotics even if symptoms improve before finishing the medication. Bacterial laryngitis typically presents with more severe symptoms than viral cases, including high fever, severe throat pain, difficulty swallowing, and sometimes visible pus or exudate on examination.
Some key points to consider when treating laryngitis with amoxicillin include:
- The importance of completing the full course of antibiotics to ensure complete eradication of the bacterial infection
- The need for supportive measures like voice rest, adequate hydration, and avoiding irritants such as smoking to aid in recovery
- The potential for antibiotic resistance or non-bacterial causes if symptoms do not improve within 48-72 hours of starting amoxicillin, which would require follow-up with a healthcare provider and possible alternative treatment. As stated in the guideline 1, misuse of antibiotics exposes patients and the healthcare system to unnecessary costs and can have serious health and cost impacts due to bacterial antibiotic resistance.
From the Research
Causes of Laryngitis that Improve with Amoxicillin
- Bacterial infections: Amoxicillin is effective against bacterial infections, which can cause laryngitis 2.
- Specific bacterial strains: Amoxicillin may be effective against specific bacterial strains that cause laryngitis, although the evidence is limited 2.
Limitations of Current Evidence
- Lack of direct evidence: There is no direct evidence that amoxicillin improves laryngitis symptoms in the provided studies 3, 4, 5.
- Indirect evidence: Some studies suggest that antibiotics, including amoxicillin, may be beneficial in treating laryngitis, but the evidence is not conclusive 6, 2.
- Variability in treatment recommendations: Different guidelines recommend different antibiotics, including amoxicillin, for the treatment of laryngitis, but there is no uniformity in these recommendations 2.