Throat

Introduction

Most of the time, a sore throat is caused by a viral infection or allergies. In these cases, you may also have associated nasal congestion, cough, runny nose or bilateral ear pain. However, when the pain lasts more than a week, is severe or is associated with high fever, difficulty swallowing or difficulty breathing, or causes swelling of one side of the throat, it may be due to a bacterial infection.

Treatment

For mild to moderate throat pain without fever, consider ibuprofen. If you have a cough, runny nose, or a hoarse voice, your sore throat is most likely due to a viral illness and antibiotics are unlikely to help. If you have an associated high fever or if the throat pain lasts over 3 days and is severe, you may have a bacterial infection and can take amoxicillin (or amoxicillin-clavulanate if regular amoxicillin is unavailable).

Most sore throats are NOT strep throat and do NOT need antibiotics. Millions of people suffer side effects every year, including uncontrollable diarrhea, after taking antibiotics for a sore throat when one is not necessary. Before considering antibiotics, is highly recommended to try ibuprofen first and wait to see if your symptoms resolve, especially if you do not have a fever.

When To Worry

Seek immediate medical care if you have any of the following:

  • any difficulty breathing
  • audible high-pitched noise with breathing or wheezing
  • visible swelling of one side of the throat

Pediatrics

Quick Guide

If you have

  • mild sore throat < 10 days
  • nasal congestion
  • mild cough
  • mild facial pressure
  • no fever

You may have

viral upper respiratory infection or allergic rhinitis (seasonal allergies or "hay fever")

Consider using

benzocaine-menthol lozenges (generic for Cepacol®) 1 lozenge every 2 hours as needed

OR

oxymetazoline nasal spray (generic for Afrin®) 2 sprays in each nostril every 12 hours for not more than 3 days

OR

fluticasone propionate nasal spray (generic for Flonase®) 1 spray in each nostril once daily

OR

ibuprofen 600 mg every 6 hours as needed for pain

OR

acetaminophen 1000 mg every 6-8 hours as needed for pain (do not exceed 3000 mg per day)

OR

Pediatrics

For children age 17 and under

ibuprofen 10 mg/kg every 6 hours as needed; maximum 400 mg per dose

acetaminophen 15 mg/kg every 6 hours as needed; maximum 500 mg per dose

fluticasone propionate nasal spray (generic for Flonase®) 1 spray in each nostril twice a day

oxymetazoline nasal spray (generic for Afrin®) should not be used in children

See also: Pediatrics

If you have

  • fever
  • white pus in your throat
  • NO cough
  • NO nasal congestion
  • tender lymph nodes ("swollen glands") in neck

You may have

strep throat

Consider using

amoxicillin-clavulanate 875 mg-125 mg twice daily for 10 days

Note: if amoxicillin is available, consider using amoxicillin instead of amoxicillin-clavulanate

Note: if amoxicillin is unavailable or if an allergy to penicillins is present, azithromycin may be considered as an alternative, although it may be less effective

OR

Pediatrics

For children age 17 and under

amoxicillin 25 mg/kg per dose twice a day for 10 days; maximum 500 mg per dose

OR

cephalexin 20 mg/kg per dose twice a day for 10 days; maximum 500 mg per dose

OR

azithromycin 12 mg/kg once per day for 5 days; maximum 500 mg per dose

Azithromycin is generally a poor choice of antibiotic to treat strep throat. Azithromycin should only be used if there is a severe allergy to pencillins and under the direction of a physician.

See also: Pediatrics

If you have

  • severe sore throat
  • visible swelling on one side of the throat
  • fever
  • muffled voice
  • difficulty swallowing
  • difficulty breathing
  • drooling/pooling saliva

You may have

peritonsillar abscess or retropharyngeal abscess

You should

seek emergency medical care

Reference

amoxicillin-clavulanate

Amoxicillin-clavulanate (generic for Augmentin) is an antibiotic. It can be used to treat skin infections like bite wounds, ear infections, sinus infections, tooth infections, and other infections. This medication should be taken with food.

Prescription only

InfectionMedication

amoxicillin-clavulanate pediatric

Amoxicillin-clavulanate (generic for Augmentin) is an antibiotic. It can be used to treat skin infections like bite wounds, ear infections, sinus infections, tooth infections, and other infections. This medication should be taken with food.

Prescription only

InfectionMedication

amoxicillin-clavulanate suspension

Amoxicillin-clavulanate (generic for Augmentin) is an antibiotic. It can be used to treat skin infections like bite wounds, ear infections, sinus infections, tooth infections, and other infections. This medication should be taken with food.

Prescription only

InfectionMedication

amoxicillin capsule

Amoxicillin is an antibiotic. It is used to treat infections of the ear, nose, throat, urine, skin, and lungs.

Prescription only

InfectionMedication

amoxicillin pediatric

Amoxicillin is an antibiotic. It is used to treat infections of the ear, nose, throat, urine, skin, and lungs.

Prescription only

PediatricsMedication

amoxicillin

Amoxicillin is an antibiotic. It is used to treat infections of the ear, nose, throat, urine, skin, and lungs.

Prescription only

PediatricsMedication

benzocaine-menthol

Benzocaine-menthol lozenge (generic for Cepacol) treats sore throat and mouth irritation.

GeneralMedication

ibuprofen

Ibuprofen (generic for Motrin, generic for Advil) is a pain reliever and the most commonly used non-steroidal anti-inflammatory drug (NSAID). Ibuprofen is used to treat pain.

GeneralMedication

acetaminophen

Acetaminophen (generic for Tylenol) is a pain reliever and fever reducer. Acetaminophen is used to treat pain.

GeneralMedication

ibuprofen blisterpack

Ibuprofen (generic for Motrin, generic for Advil) is a pain reliever and the most commonly used non-steroidal anti-inflammatory drug (NSAID). Ibuprofen is used to treat pain.

GeneralMedication

acetaminophen blisterpack

Acetaminophen (generic for Tylenol) is a pain reliever and fever reducer. Acetaminophen is used to treat pain.

GeneralMedication

acetaminophen pack

Acetaminophen (generic for Tylenol) is a pain reliever and fever reducer. Acetaminophen is used to treat pain.

GeneralMedication

ibuprofen pack

Ibuprofen (generic for Motrin, generic for Advil) is a pain reliever and the most commonly used non-steroidal anti-inflammatory drug (NSAID). Ibuprofen is used to treat pain.

GeneralMedication

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