Best outpatient Rx for pharyngitis

Introduction

Pharyngitis, more commonly known as a sore throat, is an inflammation of the throat and tonsils. While often caused by viral infections, pharyngitis can be caused by bacterial infections, allergies, acid reflux, and other factors. In this article, we'll explore the symptoms and causes of pharyngitis, common treatments, how to differentiate viral and bacterial cases, ways to prevent complications of strep throat, and when it's important to see a healthcare provider for throat pain.

Symptoms and Causes of Pharyngitis

The main symptom of pharyngitis is a sore, scratchy throat that often worsens when swallowing. Other common signs include:

• Fever
• Headache
• Fatigue
• Swollen lymph nodes in the neck. 4,9

Depending on the underlying cause, there may be other symptoms. Viral pharyngitis frequently also causes coughing, nasal congestion, and diarrhea. 2,6 Bacterial infections like strep throat, on the other hand, tend to cause high fever and visible white patches on the tonsils. 2,6

Viruses cause around 90% of pharyngitis cases, with common viruses including rhinovirus (the main cause of the common cold), influenza, adenovirus, and coronavirus. 4,5 While unpleasant, most viral infections will get better within a week or two without specific treatment. 1,2

Bacterial infections, particularly strep throat caused by Group A Streptococcus bacteria, are less common but can lead to serious complications if left untreated. 7,8 Rare bacterial causes include gonorrhea and diphtheria. 2,3 Getting the right diagnosis and antibiotic treatment are important for managing bacterial pharyngitis and preventing long-term health issues like rheumatic fever and kidney problems. 12

In some instances, pharyngitis may stem from non-infectious factors such as allergies, dry air, acid reflux, or overuse of the voice. 3,2

Common Treatments for Sore Throat

Treatment for pharyngitis largely depends on the underlying cause. Viral infections typically resolve on their own within a week. 14,15 During this time, over-the-counter pain relievers like acetaminophen or ibuprofen can help manage discomfort and reduce inflammation. 14,15 Throat lozenges or sprays with numbing agents such as benzocaine or menthol may also provide temporary relief. 16,17 However, use these products according to the label.

For bacterial infections like strep throat, antibiotics are needed to kill off the infection and prevent complications. 18,19 Penicillin and amoxicillin are commonly prescribed, and it's important to complete the full course of treatment even if symptoms improve to avoid antibiotic resistance. 18,19

If you think you have strep throat, it's important to see a healthcare provider for proper diagnosis and treatment. Online services can connect you with licensed healthcare providers who can evaluate your symptoms, provide a diagnosis, and prescribe the right antibiotics. This convenient option allows you to access care from the comfort of your own home.

Home remedies can also offer relief for both viral and bacterial pharyngitis. Gargling with warm salt water can help reduce swelling and loosen mucus, while honey has natural soothing and antibacterial properties. 20,21 Staying hydrated by drinking plenty of fluids, such as water, broth, or herbal tea, can help keep the throat moist and relieve discomfort. 20,21

Differentiating Viral and Bacterial Pharyngitis

Distinguishing between viral and bacterial pharyngitis is necessary to determine appropriate treatment. While both types share similar symptoms, there are some key differences to consider.

Viral pharyngitis often has a more gradual onset of symptoms, including sore throat, cough, runny nose, and hoarseness. 28,29 There may be a fever, but is typically lower than in bacterial infections. 30 Symptoms usually peak within 3-5 days and resolve on their own within a week. 24,25

In contrast, bacterial pharyngitis, particularly strep throat, causes a rapid onset of severe symptoms. 26,27 These may include a sudden, intense sore throat, painful swallowing, high fever (above 101°F or 38.3°C), swollen tonsils with white patches, and enlarged lymph nodes in the neck. 28 Cough and nasal congestion are less common in bacterial infections. 28,29

To confirm the diagnosis, healthcare providers may perform a rapid strep test or throat culture. 31 Rapid strep tests can detect Streptococcus bacteria within minutes but aren’t always accurate. 32 If the rapid test is negative but strep throat is still suspected, your provider may order a throat culture to definitively identify the bacteria. 33

Accurate diagnosis is important, as viral and bacterial pharyngitis require different management approaches. Viral infections do not respond to antibiotics and are best treated with supportive care like rest, hydration, and over-the-counter pain relief. 34 Bacterial infections, on the other hand, need prompt antibiotic therapy to prevent potentially serious complications. 33,34

Preventing Complications of Strep Throat

Strep throat, caused by Group A Streptococcus bacteria, is highly contagious and can lead to serious complications if left untreated. 35,37 The bacteria spreads when an infected person coughs, sneezes, or talks, or by touching contaminated surfaces and then touching the mouth or nose. 35,37 School-age children between 5 and 15 years old are most susceptible, but anyone can get strep throat. 35,37

Prompt antibiotic treatment helps prevent complications and reduce the risk of spreading the infection to others. 41,42 Penicillin or amoxicillin are typically prescribed, as they effectively target the bacteria with few side effects. 41,42 For those with a penicillin allergy, alternative antibiotics like cephalosporins, clindamycin, azithromycin, or clarithromycin may be used. 42,43

Completing the full course of antibiotics, usually 10 days, is important even if symptoms improve earlier. 41,42 Stopping treatment early can lead to the infection coming back, antibiotic resistance, and an increased risk of complications. 41,44 Over-the-counter pain relievers like ibuprofen or acetaminophen can help relieve throat pain and fever during the treatment period. 39

Potential complications of untreated strep throat include rheumatic fever, a serious condition that can cause joint pain, rash, and permanent heart damage. 35,36 Kidney inflammation, known as post-streptococcal glomerulonephritis, is another possible complication. 36 In rare cases, strep throat can cause pediatric autoimmune neuropsychiatric disorder associated with group A streptococci (PANDAS), which affects the brain and nervous system. 35

To prevent the spread of strep throat, practice good hygiene habits like frequent handwashing, covering coughs and sneezes, and avoiding close contact with infected people. 38,40 Those diagnosed with strep throat should stay home from school or work until at least 24 hours after starting antibiotics to reduce the risk of transmission. 40

When to See a Healthcare Provider for Throat Pain

While most sore throats resolve on their own within a week, certain symptoms should be checked out. 45,46 It's important to recognize when a sore throat may be a sign of a more serious underlying issue that needs prompt evaluation and treatment. 47,48

Experts recommend seeking medical care if your sore throat:

• Lasts for more than a week without improvement 45,47
• Is accompanied by a high fever (over 101°F or 38.3°C), difficulty swallowing, or trouble breathing 47,50
• Causes severe pain or discomfort 47,50
• Results in visible swelling or a lump in the throat 47,51
• Produces blood in the saliva or phlegm 47,51
• Is accompanied by a new rash or joint pain 47,50

People with weakened immune systems, young children, and the elderly should also see a healthcare provider promptly for any sore throat, as they may be more prone to complications. 50,52

During the evaluation, your healthcare provider will examine your throat, ask about your symptoms and medical history, and may perform tests like a rapid strep test or throat culture to determine the underlying cause. 49,56 Based on the findings, they may prescribe antibiotics for bacterial infections, recommend supportive care measures, or refer you to a specialist if they think you may have a more serious condition. 46,49

For mild sore throats caused by viral infections, home care measures can help alleviate symptoms until the illness runs its course, usually within 5-7 days. 49,55 These include resting the voice, staying hydrated with warm liquids, using over-the-counter pain relievers, gargling with salt water, and using a humidifier to add moisture to the air. 50,53 Some people find relief from natural remedies like honey, which has soothing properties. 54

However, if symptoms last longer than a week or worsen despite home care, consult with a healthcare provider for further evaluation and treatment. 45,47 Prompt medical attention can help make sure you’re getting the appropriate treatment and nothing is missed.

Conclusion

Pharyngitis, or sore throat, is a common condition that can be caused by viral infections, bacterial infections, allergies, or other factors. Understanding the symptoms, causes, and treatment options can help you manage this condition and prevent potential complications. While most sore throats resolve on their own with supportive care, sometimes medical attention is necessary, particularly in cases of severe or persistent symptoms, high fever, or difficulty swallowing or breathing.

By practicing good hygiene habits, staying up to date on vaccinations, and seeking prompt treatment when needed, you can reduce your risk of developing pharyngitis. If you experience a severe or prolonged sore throat, don't hesitate to consult with a healthcare provider. With proper care and attention, you can find relief from pharyngitis and get back to feeling your best.

Citations:

<1>Mount Sinai. (n.d.). Pharyngitis - viral Information | Mount Sinai - New York. https://www.mountsinai.org/health-library/diseases-conditions/pharyngitis-viral</1>

<2>Healthline. (2019, September 25). Pharyngitis: Causes, Symptoms, and Diagnosis. https://www.healthline.com/health/pharyngitis</2>

<3>Johns Hopkins Medicine. (n.d.). Pharyngitis | Johns Hopkins Medicine. https://www.hopkinsmedicine.org/health/conditions-and-diseases/pharyngitis</3>

<4>Medical News Today. (2019, June 28). Pharyngitis: Causes, symptoms, and treatment. https://www.medicalnewstoday.com/articles/324144</4>

<5>StatPearls. (2022, August 8). Pharyngitis - StatPearls - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK519550/</5>

<6>healthdirect. (n.d.). Sore throat (pharyngitis) - symptoms, treatments and causes | healthdirect. https://www.healthdirect.gov.au/sore-throat</6>

<7>Harvard Health. (n.d.). Sore Throat (Pharyngitis) - Harvard Health. https://www.health.harvard.edu/diseases-and-conditions/sore-throat-pharyngitis-a-to-z</7>

<8>MedlinePlus. (n.d.). Pharyngitis - viral: MedlinePlus Medical Encyclopedia. https://medlineplus.gov/ency/article/001392.htm</8>

<9>Mayo Clinic. (n.d.). Sore throat-Sore throat - Symptoms & causes - Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/sore-throat/symptoms-causes/syc-20351635</9>

<10>Brookes, V. J., Henning, C. E., Worthing, K. A., & Degeling, C. (2022). Eliminate all risks: A call to reexamine the link between canine scabies and rheumatic heart disease. PLoS neglected tropical diseases, 16(11), e0010846. https://pubmed.ncbi.nlm.nih.gov/38696362/</10>

<11>Tao, M., Zhang, Y., Ding, L., & Peng, D. (2022). Risk factors of sleep-disordered breathing and poor asthma control in children with asthma. BMC pediatrics, 22(1), 616. https://pubmed.ncbi.nlm.nih.gov/38689232/</11>

<12>MedlinePlus. (n.d.). What Are the Possible Complications of Strep Throat? https://www.medicinenet.com/strep_throat_complications/views.htm</12>

<13>Mayo Clinic. (n.d.). Sore throat - Diagnosis & treatment. https://www.mayoclinic.org/diseases-conditions/sore-throat/diagnosis-treatment/drc-20351640</13>

<14>NHS. (n.d.). Sore throat. https://www.nhs.uk/conditions/sore-throat/</14>

<15>Healthline. (n.d.). Sore Throat: Treatment, Causes, Diagnosis, Symptoms & More. https://www.healthline.com/health/sore-throat</15>

<16>Penn Medicine. (n.d.). Sore Throat. https://www.pennmedicine.org/for-patients-and-visitors/patient-information/conditions-treated-a-to-z/sore-throat</16>

<17>WebMD. (n.d.). Remedies for Sore Throat: What to Do and When to See a Doctor. https://www.webmd.com/cold-and-flu/remedies-for-sore-throat</17>

<18>Mayo Clinic. (n.d.). Strep throat - Diagnosis & treatment. https://www.mayoclinic.org/diseases-conditions/strep-throat/diagnosis-treatment/drc-20350344</18>

<19>Alberta Health Services. (n.d.). Sore Throat: Care Instructions. https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=uh2986</19>

<20>Cleveland Clinic. (n.d.). 6 Sore Throat Remedies That Actually Work. https://health.clevelandclinic.org/sore-throat-remedies-that-actually-work</20>

<21>Healthline. (n.d.). Sore Throat Remedies: Best Natural Options for Relief. https://www.healthline.com/health/cold-flu/sore-throat-natural-remedies</21>

<22>GoodRx. (n.d.). Sore Throat Remedies: Which Works Best? https://www.goodrx.com/health-topic/throat/sore-throat-treatment-options-over-the-counter</22>

<23>Cardinale, F., Barattini, D. F., Sbrocca, F., Centi, A., Giuntini, G., Morariu Bordea, M., Herteg, D., Rosu, S., & Matei, C. R. (2023). The Effects of a Dietary Supplement (PediaFlù) Plus Standard of Care in Children With Acute Tonsillopharyngitis/Rhinopharyngitis: Protocol for a Randomized Controlled Trial. JMIR research protocols. https://pubmed.ncbi.nlm.nih.gov/38819917/</23>

<24>StatPearls. (n.d.). Pharyngitis. NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK519550/</24>

<25>Clinical Advisor. (n.d.). Bacterial vs. viral pharyngitis. https://www.clinicaladvisor.com/slideshow/slides/bacterial-vs-viral-pharyngitis/</25>

<26>Centor, R. M., & Atkinson, T. P. (2018). Pharyngitis: Approach to diagnosis and treatment. NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7145142/</26>

<27>Medscape. (n.d.). How are viral and bacterial pharyngitis differentiated? https://www.medscape.com/answers/302460-86863/how-are-viral-and-bacterial-pharyngitis-differentiated</27>

<28>American Academy of Family Physicians. (2004). Pharyngitis. https://www.aafp.org/afp/2004/0315/p1465.html</28>

<29>Healthline. (n.d.). Pharyngitis: Causes, Symptoms, and Diagnosis. https://www.healthline.com/health/pharyngitis</29>

<30>ScienceDirect. (n.d.). Viral Pharyngitis - an overview. https://www.sciencedirect.com/topics/medicine-and-dentistry/viral-pharyngitis</30>

<31>Harvard Health. (n.d.). Sore Throat (Pharyngitis). https://www.health.harvard.edu/diseases-and-conditions/sore-throat-pharyngitis-a-to-z</31>

<32>Infectious Disease and Antimicrobial Agents. (n.d.). Sore Throat (Pharyngitis). http://www.antimicrobe.org/e36.asp</32>

<33>Johns Hopkins Medicine. (n.d.). Pharyngitis. https://www.hopkinsmedicine.org/health/conditions-and-diseases/pharyngitis</33>

<34>MedicineNet. (n.d.). How Do I Know If My Sore Throat Is Viral or Bacterial? https://www.medicinenet.com/how_do_i_know_my_sore_throat_is_viral_or_bacterial/article.htm</34>

<35>Mayo Clinic. (n.d.). Strep throat - Strep throat - Symptoms & causes. https://www.mayoclinic.org/diseases-conditions/strep-throat/symptoms-causes/syc-20350338</35>

<36>Columbia Doctors. (n.d.). Strep Throat Complications Information. https://www.columbiadoctors.org/health-library/article/strep-throat-complications/</36>

<37>Centers for Disease Control and Prevention. (n.d.). About Strep Throat | Group A Strep | CDC. https://www.cdc.gov/group-a-strep/about/strep-throat.html</37>

<38>Everyday Health. (n.d.). Strep Throat Complications and How to Prevent Them. https://www.everydayhealth.com/strep-throat/how-deal-with-strep-throat-complications-prevention-strategies/</38>

<39>Mayo Clinic. (n.d.). Strep throat-Strep throat - Diagnosis & treatment. https://www.mayoclinic.org/diseases-conditions/strep-throat/diagnosis-treatment/drc-20350344</39>

<40>Nationwide Children's Hospital. (n.d.). Strep Throat (Bacterial): Symptoms, Diagnosis and Treatment. https://www.nationwidechildrens.org/conditions/strep-throat</40>

<41>WebMD. (n.d.). What Are the Treatments for Strep Throat? https://www.webmd.com/oral-health/understanding-strep-throat-treatment</41>

<42>Drugs.com. (n.d.). What is the best antibiotic to treat strep throat? https://www.drugs.com/medical-answers/best-antibiotic-treat-strep-throat-3121657/</42>

<43>GoodRx. (n.d.). What Is Strep Throat (Streptococcal Pharyngitis)? https://www.goodrx.com/health-topic/infections/antibiotic-treatment-strep-throat</43>

<44>VeryWell Health. (n.d.). How Strep Throat Is Treated. https://www.verywellhealth.com/strep-throat-treatment-1191993</44>

<45>GoodRx. (n.d.). When to See a Doctor for a Sore Throat. https://www.goodrx.com/conditions/cold-symptoms/when-to-see-doctor-for-sore-throat</45>

<46>UCLA Health. (n.d.). When to see a doctor for a sore throat. https://www.uclahealth.org/news/article/when-to-see-a-doctor-for-a-sore-throat</46>

<47>Primary Care Walk-in Medical Clinic. (n.d.). When to See Your Doctor About a Sore Throat. https://www.primarycarewalkinmedicalclinic.com/blog/when-to-see-your-doctor-about-a-sore-throat</47>

<48>Verywellhealth. (2022, March 29). Reasons You Should See a Healthcare Provider If You Have a Sore Throat. https://www.verywellhealth.com/symptoms-of-sore-throat-770767</48>

<49>Verywellhealth. (2022, March 29). Causes of Throat Pain and Treatment Options. https://www.verywellhealth.com/throat-pain-4174240</49>

<50>SmartClinic Urgent Care. (n.d.). When to See a Doctor About a Sore Throat. https://www.mysmartclinic.com/blog/when-to-see-a-doctor-about-a-sore-throat</50>

<51>ENT and Allergy Associates. (2020, February). When Should you See a Throat Specialist? https://www.entandallergy.com/blog/2020/february/when-should-you-see-a-throat-specialist-/</51>

<52>Healthgrades. (n.d.). Strep Throat Symptoms | When to See a Doctor for a Sore Throat. https://www.healthgrades.com/right-care/ear-nose-and-throat/when-to-see-a-doctor-for-a-sore-throat</52>

<53>Akca, G., Akca, U., & Sahin, M. K. (2022). Knowledge, attitudes and practices of general practitioners and paediatricians towards Group A beta-haemolytic streptococcal tonsillopharyngitis: A cross-sectional study from Türkiye. Australian journal of general practice. https://pubmed.ncbi.nlm.nih.gov/37666786/</53>

<54>Schönknecht, K., Kulawik, A. M., Krauss, H., & Fal, A. M. (2022). EFFICACY AND SAFETY OF CANDELABRA ALOE EXTRACT (ALOE ARBORESCENS MILL.) IN PREVENTION AND TREATMENT OF UPPER RESPIRATORY TRACT INFECTIONS OF VARIOUS AETIOLOGIES. Wiadomosci lekarskie (Warsaw, Poland : 1960). https://pubmed.ncbi.nlm.nih.gov/36723337/</54>

<55>Medical News Today. (2022). Sore throat: Causes, symptoms, and when to see a doctor. https://www.medicalnewstoday.com/articles/311449</55>

<56>Cleveland Clinic. (n.d.). Sore Throat: Symptoms, Causes & Treatment. https://my.clevelandclinic.org/health/diseases/8274-sore-throat-pharyngitis</56>