From the Guidelines
Antibiotics are not recommended for laryngitis as it is most commonly caused by viral infections, not bacterial ones. The majority of cases of laryngitis are self-limited, with most patients experiencing symptomatic improvement within 7 to 10 days irrespective of treatment, as noted in a study published in 2018 1. This study emphasizes that acute laryngitis is often caused by parainfluenza, rhinovirus, influenza, and adenovirus, and that antibiotics are not effective in treating acute laryngitis in terms of objective outcomes.
Some key points to consider when managing laryngitis include:
- Most cases resolve on their own with supportive care such as voice rest, staying hydrated, using a humidifier, and taking over-the-counter pain relievers like acetaminophen or ibuprofen.
- Antibiotics may be warranted in select circumstances, such as in immunosuppressed patients or those with bacterial infections like laryngeal tuberculosis or pertussis, as mentioned in the study 1.
- The misuse of antibiotics can lead to unnecessary costs, side effects like rash, abdominal pain, diarrhea, and vomiting, and contribute to bacterial antibiotic resistance, which has serious health and cost impacts, as highlighted in the study 1.
- If symptoms persist beyond two weeks, worsen significantly, or are accompanied by difficulty breathing or swallowing, medical attention should be sought immediately as these could indicate a more serious condition requiring different treatment.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Antibiotic Treatment for Laryngitis
- The effectiveness of antibiotics in treating acute laryngitis has been assessed in several studies 2, 3, 4.
- These studies found that antibiotics do not appear to be effective in treating acute laryngitis when assessing objective outcomes, such as objective voice scores 2, 3, 4.
- However, some antibiotics, such as erythromycin, may be beneficial for some subjective outcomes, such as reducing voice disturbance at one week and cough at two weeks 2, 3, 4.
- Fusafungine, an antibiotic used in one study, was found to increase the cure rate at day five, but no significant differences were found at days 8 and 28 2.
Recommended Antibiotics
- A study assessing the quality of clinical guidelines for the management of laryngitis and pharyngitis found that the use of penicillin, erythromycin, ampicillin, amoxicillin, azithromycin, and clarithromycin were recommended in 75% of the guidelines that presented pharmacological measures 5.
- However, no uniformity was observed in the recommendations of these guidelines with regard to non-pharmacological and pharmacological treatment 5.
Limitations of Antibiotic Treatment
- The included RCTs had important methodological problems, and the modest benefits from antibiotics may not outweigh their cost, adverse effects, or negative consequences for antibiotic resistance patterns 2, 3, 4.
- The implications for practice are that prescribing antibiotics should not be done in the first instance as they will not objectively improve symptoms 3, 4.