Pharyngitis medical therapy: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
Line 28: Line 28:
* Honey has long been used for treating sore throats due to its [[antiseptic]] properties.<ref>{{cite journal |author=Ramoutsaki I, Papadakis C, Ramoutsakis I, Helidonis E |title=Therapeutic methods used for otolaryngological problems during the Byzantine period |journal=Ann. Otol. Rhinol. Laryngol. |volume=111|issue=6 |pages=553-7 |year=2002 |pmid=12090712}}</ref>
* Honey has long been used for treating sore throats due to its [[antiseptic]] properties.<ref>{{cite journal |author=Ramoutsaki I, Papadakis C, Ramoutsakis I, Helidonis E |title=Therapeutic methods used for otolaryngological problems during the Byzantine period |journal=Ann. Otol. Rhinol. Laryngol. |volume=111|issue=6 |pages=553-7 |year=2002 |pmid=12090712}}</ref>
* Swallowing a couple teaspoons of raw lemon or lime juice several times a day may help destroy microorganisms in bacteria-related throat infections.<ref name="urlUSE OF CITRIC ACID AS ANTIMICROBIAL AGENT OR ENHANCER OR AS ANTICANCER AGENT - SHANBROM TECH LLC">{{cite web |url=http://www.freepatentsonline.com/EP1331947.html |title=USE OF CITRIC ACID AS ANTIMICROBIAL AGENT OR ENHANCER OR AS ANTICANCER AGENT - SHANBROM TECH LLC |format= |work= |accessdate=}}</ref> Research also shows that lemon juice may destroy some viruses such as HIV.<ref name="urlLemon juice may kill AIDS virus: research - ABC News (Australian Broadcasting Corporation)">{{cite web |url=http://www.abc.net.au/news/stories/2004/07/12/1152319.htm |title=Lemon juice may kill AIDS virus: research - ABC News (Australian Broadcasting Corporation) |format= |work= |accessdate=}}</ref> This remedy should be started during the first or second day of sickness because citric acid can irritate a patient's throat tissues after pharyngitis becomes too widespread.  If this is the case, the patient may try a diluted solution of lemon, honey and tea (or lemon with hot water).
* Swallowing a couple teaspoons of raw lemon or lime juice several times a day may help destroy microorganisms in bacteria-related throat infections.<ref name="urlUSE OF CITRIC ACID AS ANTIMICROBIAL AGENT OR ENHANCER OR AS ANTICANCER AGENT - SHANBROM TECH LLC">{{cite web |url=http://www.freepatentsonline.com/EP1331947.html |title=USE OF CITRIC ACID AS ANTIMICROBIAL AGENT OR ENHANCER OR AS ANTICANCER AGENT - SHANBROM TECH LLC |format= |work= |accessdate=}}</ref> Research also shows that lemon juice may destroy some viruses such as HIV.<ref name="urlLemon juice may kill AIDS virus: research - ABC News (Australian Broadcasting Corporation)">{{cite web |url=http://www.abc.net.au/news/stories/2004/07/12/1152319.htm |title=Lemon juice may kill AIDS virus: research - ABC News (Australian Broadcasting Corporation) |format= |work= |accessdate=}}</ref> This remedy should be started during the first or second day of sickness because citric acid can irritate a patient's throat tissues after pharyngitis becomes too widespread.  If this is the case, the patient may try a diluted solution of lemon, honey and tea (or lemon with hot water).
===Medical treatment for Acute Pharyngitis===
====Systemic Therapy====
#Analgesics
Analgesics are prescribed for moderate to severe pain. Acetaminophen , Nonsteroidal antiinflammatory  drugs (NSAID)  have shown to decrease pain symptoms. They may also help in reducing fever and inflammation.<ref name="Thomas-2000">{{Cite journal  | last1 = Thomas | first1 = M. | last2 = Del Mar | first2 = C. | last3 = Glasziou | first3 = P. | title = How effective are treatments other than antibiotics for acute sore throat? | journal = Br J Gen Pract | volume = 50 | issue = 459 | pages = 817-20 | month = Oct | year = 2000 | doi =  | PMID = 11127175 }}</ref><ref name="Gehanno-2003">{{Cite journal  | last1 = Gehanno | first1 = P. | last2 = Dreiser | first2 = RL. | last3 = Ionescu | first3 = E. | last4 = Gold | first4 = M. | last5 = Liu | first5 = JM. | title = Lowest effective single dose of diclofenac for antipyretic and analgesic effects in acute febrile sore throat. | journal = Clin Drug Investig | volume = 23 | issue = 4 | pages = 263-71 | month =  | year = 2003 | doi =  | PMID = 17535039 }}</ref><ref name="Schachtel-1993">{{Cite journal  | last1 = Schachtel | first1 = BP. | last2 = Thoden | first2 = WR. | title = A placebo-controlled model for assaying systemic analgesics in children. | journal = Clin Pharmacol Ther | volume = 53 | issue = 5 | pages = 593-601 | month = May | year = 1993 | doi =  | PMID = 8491069 }}</ref><ref name="Bertin-1991">{{Cite journal  | last1 = Bertin | first1 = L. | last2 = Pons | first2 = G. | last3 = d'Athis | first3 = P. | last4 = Lasfargues | first4 = G. | last5 = Maudelonde | first5 = C. | last6 = Duhamel | first6 = JF. | last7 = Olive | first7 = G. | title = Randomized, double-blind, multicenter, controlled trial of ibuprofen versus acetaminophen (paracetamol) and placebo for treatment of symptoms of tonsillitis and pharyngitis in children. | journal = J Pediatr | volume = 119 | issue = 5 | pages = 811-4 | month = Nov | year = 1991 | doi =  | PMID = 1941391 }}</ref><ref name="Benarrosh-">{{Cite journal  | last1 = Benarrosh | first1 = C. | title = [Multicenter double blind study of tiaprofenic acid versus placebo in tonsillitis and pharyngitis in children]. | journal = Arch Fr Pediatr | volume = 46 | issue = 7 | pages = 541-6 | month =  | year =  | doi =  | PMID = 2688592 }}</ref><ref name="Eccles-2003">{{Cite journal  | last1 = Eccles | first1 = R. | last2 = Loose | first2 = I. | last3 = Jawad | first3 = M. | last4 = Nyman | first4 = L. | title = Effects of acetylsalicylic acid on sore throat pain and other pain symptoms associated with acute upper respiratory tract infection. | journal = Pain Med | volume = 4 | issue = 2 | pages = 118-24 | month = Jun | year = 2003 | doi =  | PMID = 12873261 }}</ref>Aspirin should be avoided in children as it may cause Reye's syndrome .Only for severe pain codeine may be added to the NSAID.
#Glucocorticoids
They may alleviate pain , and may also be beneficial in patients of Group A streptococcal pharyngitis. No benefits were obtained by adding single dose glucocorticoid to antimicrobial therapy in children.<ref name="Olympia-2005">{{Cite journal  | last1 = Olympia | first1 = RP. | last2 = Khine | first2 = H. | last3 = Avner | first3 = JR. | title = Effectiveness of oral dexamethasone in the treatment of moderate to severe pharyngitis in children. | journal = Arch Pediatr Adolesc Med | volume = 159 | issue = 3 | pages = 278-82 | month = Mar | year = 2005 | doi = 10.1001/archpedi.159.3.278 | PMID = 15753273 }}</ref><ref name="O'Brien-1993">{{Cite journal  | last1 = O'Brien | first1 = JF. | last2 = Meade | first2 = JL. | last3 = Falk | first3 = JL. | title = Dexamethasone as adjuvant therapy for severe acute pharyngitis. | journal = Ann Emerg Med | volume = 22 | issue = 2 | pages = 212-5 | month = Feb | year = 1993 | doi =  | PMID = 8427434 }}</ref><ref name="Bulloch-2003">{{Cite journal  | last1 = Bulloch | first1 = B. | last2 = Kabani | first2 = A. | last3 = Tenenbein | first3 = M. | title = Oral dexamethasone for the treatment of pain in children with acute pharyngitis: a randomized, double-blind, placebo-controlled trial. | journal = Ann Emerg Med | volume = 41 | issue = 5 | pages = 601-8 | month = May | year = 2003 | doi = 10.1067/mem.2003.136 | PMID = 12712025 }}</ref><ref name="Marvez-Valls-2002">{{Cite journal  | last1 = Marvez-Valls | first1 = EG. | last2 = Stuckey | first2 = A. | last3 = Ernst | first3 = AA. | title = A randomized clinical trial of oral versus intramuscular delivery of steroids in acute exudative pharyngitis. | journal = Acad Emerg Med | volume = 9 | issue = 1 | pages = 9-14 | month = Jan | year = 2002 | doi =  | PMID = 11772663 }}</ref><ref name="Roy-2004">{{Cite journal  | last1 = Roy | first1 = M. | last2 = Bailey | first2 = B. | last3 = Amre | first3 = DK. | last4 = Girodias | first4 = JB. | last5 = Bussières | first5 = JF. | last6 = Gaudreault | first6 = P. | title = Dexamethasone for the treatment of sore throat in children with suspected infectious mononucleosis: a randomized, double-blind, placebo-controlled, clinical trial. | journal = Arch Pediatr Adolesc Med | volume = 158 | issue = 3 | pages = 250-4 | month = Mar | year = 2004 | doi = 10.1001/archpedi.158.3.250 | PMID = 14993084 }}</ref><ref name="Niland-2006">{{Cite journal  | last1 = Niland | first1 = ML. | last2 = Bonsu | first2 = BK. | last3 = Nuss | first3 = KE. | last4 = Goodman | first4 = DG. | title = A pilot study of 1 versus 3 days of dexamethasone as add-on therapy in children with streptococcal pharyngitis. | journal = Pediatr Infect Dis J | volume = 25 | issue = 6 | pages = 477-81 | month = Jun | year = 2006 | doi = 10.1097/01.inf.0000219469.95772.3f | PMID = 16732143 }}</ref><ref name="Wing-2010">{{Cite journal  | last1 = Wing | first1 = A. | last2 = Villa-Roel | first2 = C. | last3 = Yeh | first3 = B. | last4 = Eskin | first4 = B. | last5 = Buckingham | first5 = J. | last6 = Rowe | first6 = BH. | title = Effectiveness of corticosteroid treatment in acute pharyngitis: a systematic review of the literature. | journal = Acad Emerg Med | volume = 17 | issue = 5 | pages = 476-83 | month = May | year = 2010 | doi = 10.1111/j.1553-2712.2010.00723.x | PMID = 20536799 }}</ref><ref name="Hayward-2012">{{Cite journal  | last1 = Hayward | first1 = G. | last2 = Thompson | first2 = MJ. | last3 = Perera | first3 = R. | last4 = Glasziou | first4 = PP. | last5 = Del Mar | first5 = CB. | last6 = Heneghan | first6 = CJ. | title = Corticosteroids as standalone or add-on treatment for sore throat. | journal = Cochrane Database Syst Rev | volume = 10 | issue =  | pages = CD008268 | month =  | year = 2012 | doi = 10.1002/14651858.CD008268.pub2 | PMID = 23076943 }}</ref>Since there are safer and more effective alternatives than glucocorticoids for pain relief and their long term use come with a few side effects they not recommendedfor symptomatic relief of throat pain.However in a few conditions like infectious mononucleosis a short term may  be help in alleviating pain.


==References==
==References==

Revision as of 18:46, 24 January 2014

Pharyngitis Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Pharyngitis from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic study of choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

Chest X Ray

CT

Ultrasound

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Pharyngitis medical therapy On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Pharyngitis medical therapy

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Pharyngitis medical therapy

CDC on Pharyngitis medical therapy

Pharyngitis medical therapy in the news

Blogs on Pharyngitis medical therapy

Directions to Hospitals Treating Type page name here

Risk calculators and risk factors for Pharyngitis medical therapy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Medical Therapy

There are three types of treatment: symptomatic, remedial and preventive. Symptomatic treatments are aimed at reducing pain and symptoms. Remedial treatments attempt to cure pharyngitis by reducing its spread and speeding up the healing process. Preventive treatments attempt to block the start of an infection.

Remedial treatments are mostly effective for bacterial infections such as streptococcal infections. For viral infections, even with treatment, most cases of pharyngitis will still settle spontaneously within a few days. Hence the most popular method of treatment is symptomatic. Many preventive treatments are also remedial, thus those two treatments will be listed in the same section.

Twenty-two non-antibiotic managements for sore throat have been studied in controlled trials.[1]Analgesics are among the most effective, but there are many simple measures that can also be used.

Symptomatic treatments

  • Analgesics such as NSAIDs can help reduce the pain associated with a sore throat.[1]
  • Throat lozenges (cough medicine) are often used for short-term pain relief.
  • Avoid foods and liquids highly acidic in nature, as they will provoke temporary periods of intense pain.
  • Warm tea (true or Tisane) or soup can help temporarily alleviate the pain of a sore throat.
  • Cold beverages, popsicles and ice cubes numb the nerves of the throat somewhat, alleviating the pain for a brief time.
  • Mouthwash (when gargled) reduces the pain but only for a brief time.
  • Drinking heavy amounts of liquid reduces the pain for a short time.
  • Peppermint candy might help with some cases as well as other hard candies. It will reduce the pain for a short time.
  • Yogurt has been shown to help alleviate the pain temporarily by coating the affected area. Milk also has the same effect.
  • Gargling with warm saline solution may help reduce mucus. [2] While it is a popular household remedy, there is little evidence that it provides any long-term benefit.

Remedial and preventive treatments

Performing remedial treatments early when a patient's throat begins to feel scratchy may help the infection from spreading to the rest of the throat and back of the mouth, which can result in difficulty in swallowing. Treatment should begin the first or second day of the illness, however if the patient has a cold or the flu, the infection may still continue to spread to other areas such as the ears through the eustachian tube (causing an earache) and to the lungs through the trachea (causing a cough). Healthy people who will be in frequent contact with someone with pharyngitis may also try the measures below, of which some can be also be preventive, to help inhibit the start of an infection.

  • The use of antibiotics is a helpful remedial treatment when a bacterial infection is the cause of the sore throat. For viral sore throats, antibiotics have no effect.
  • Honey has long been used for treating sore throats due to its antiseptic properties.[3]
  • Swallowing a couple teaspoons of raw lemon or lime juice several times a day may help destroy microorganisms in bacteria-related throat infections.[4] Research also shows that lemon juice may destroy some viruses such as HIV.[5] This remedy should be started during the first or second day of sickness because citric acid can irritate a patient's throat tissues after pharyngitis becomes too widespread. If this is the case, the patient may try a diluted solution of lemon, honey and tea (or lemon with hot water).

Medical treatment for Acute Pharyngitis

Systemic Therapy

  1. Analgesics

Analgesics are prescribed for moderate to severe pain. Acetaminophen , Nonsteroidal antiinflammatory drugs (NSAID) have shown to decrease pain symptoms. They may also help in reducing fever and inflammation.[6][7][8][9][10][11]Aspirin should be avoided in children as it may cause Reye's syndrome .Only for severe pain codeine may be added to the NSAID.

  1. Glucocorticoids

They may alleviate pain , and may also be beneficial in patients of Group A streptococcal pharyngitis. No benefits were obtained by adding single dose glucocorticoid to antimicrobial therapy in children.[12][13][14][15][16][17][18][19]Since there are safer and more effective alternatives than glucocorticoids for pain relief and their long term use come with a few side effects they not recommendedfor symptomatic relief of throat pain.However in a few conditions like infectious mononucleosis a short term may be help in alleviating pain.

References

  1. ↑ 1.0 1.1 Thomas M, Del Mar CB, Glasziou P. (2000). "How effective are treatments other than antibiotics for acute sore throat?" (PDF). Br J GP. 50 (459): 817–820. PMID 11127175.
  2. ↑ "Sore throat: Self-care - MayoClinic.com". Retrieved 2007-09-17.
  3. ↑ Ramoutsaki I, Papadakis C, Ramoutsakis I, Helidonis E (2002). "Therapeutic methods used for otolaryngological problems during the Byzantine period". Ann. Otol. Rhinol. Laryngol. 111 (6): 553–7. PMID 12090712.
  4. ↑ "USE OF CITRIC ACID AS ANTIMICROBIAL AGENT OR ENHANCER OR AS ANTICANCER AGENT - SHANBROM TECH LLC".
  5. ↑ "Lemon juice may kill AIDS virus: research - ABC News (Australian Broadcasting Corporation)".
  6. ↑ Thomas, M.; Del Mar, C.; Glasziou, P. (2000). "How effective are treatments other than antibiotics for acute sore throat?". Br J Gen Pract. 50 (459): 817–20. PMID 11127175. Unknown parameter |month= ignored (help)
  7. ↑ Gehanno, P.; Dreiser, RL.; Ionescu, E.; Gold, M.; Liu, JM. (2003). "Lowest effective single dose of diclofenac for antipyretic and analgesic effects in acute febrile sore throat". Clin Drug Investig. 23 (4): 263–71. PMID 17535039.
  8. ↑ Schachtel, BP.; Thoden, WR. (1993). "A placebo-controlled model for assaying systemic analgesics in children". Clin Pharmacol Ther. 53 (5): 593–601. PMID 8491069. Unknown parameter |month= ignored (help)
  9. ↑ Bertin, L.; Pons, G.; d'Athis, P.; Lasfargues, G.; Maudelonde, C.; Duhamel, JF.; Olive, G. (1991). "Randomized, double-blind, multicenter, controlled trial of ibuprofen versus acetaminophen (paracetamol) and placebo for treatment of symptoms of tonsillitis and pharyngitis in children". J Pediatr. 119 (5): 811–4. PMID 1941391. Unknown parameter |month= ignored (help)
  10. ↑ Benarrosh, C. "[Multicenter double blind study of tiaprofenic acid versus placebo in tonsillitis and pharyngitis in children]". Arch Fr Pediatr. 46 (7): 541–6. PMID 2688592.
  11. ↑ Eccles, R.; Loose, I.; Jawad, M.; Nyman, L. (2003). "Effects of acetylsalicylic acid on sore throat pain and other pain symptoms associated with acute upper respiratory tract infection". Pain Med. 4 (2): 118–24. PMID 12873261. Unknown parameter |month= ignored (help)
  12. ↑ Olympia, RP.; Khine, H.; Avner, JR. (2005). "Effectiveness of oral dexamethasone in the treatment of moderate to severe pharyngitis in children". Arch Pediatr Adolesc Med. 159 (3): 278–82. doi:10.1001/archpedi.159.3.278. PMID 15753273. Unknown parameter |month= ignored (help)
  13. ↑ O'Brien, JF.; Meade, JL.; Falk, JL. (1993). "Dexamethasone as adjuvant therapy for severe acute pharyngitis". Ann Emerg Med. 22 (2): 212–5. PMID 8427434. Unknown parameter |month= ignored (help)
  14. ↑ Bulloch, B.; Kabani, A.; Tenenbein, M. (2003). "Oral dexamethasone for the treatment of pain in children with acute pharyngitis: a randomized, double-blind, placebo-controlled trial". Ann Emerg Med. 41 (5): 601–8. doi:10.1067/mem.2003.136. PMID 12712025. Unknown parameter |month= ignored (help)
  15. ↑ Marvez-Valls, EG.; Stuckey, A.; Ernst, AA. (2002). "A randomized clinical trial of oral versus intramuscular delivery of steroids in acute exudative pharyngitis". Acad Emerg Med. 9 (1): 9–14. PMID 11772663. Unknown parameter |month= ignored (help)
  16. ↑ Roy, M.; Bailey, B.; Amre, DK.; Girodias, JB.; Bussières, JF.; Gaudreault, P. (2004). "Dexamethasone for the treatment of sore throat in children with suspected infectious mononucleosis: a randomized, double-blind, placebo-controlled, clinical trial". Arch Pediatr Adolesc Med. 158 (3): 250–4. doi:10.1001/archpedi.158.3.250. PMID 14993084. Unknown parameter |month= ignored (help)
  17. ↑ Niland, ML.; Bonsu, BK.; Nuss, KE.; Goodman, DG. (2006). "A pilot study of 1 versus 3 days of dexamethasone as add-on therapy in children with streptococcal pharyngitis". Pediatr Infect Dis J. 25 (6): 477–81. doi:10.1097/01.inf.0000219469.95772.3f. PMID 16732143. Unknown parameter |month= ignored (help)
  18. ↑ Wing, A.; Villa-Roel, C.; Yeh, B.; Eskin, B.; Buckingham, J.; Rowe, BH. (2010). "Effectiveness of corticosteroid treatment in acute pharyngitis: a systematic review of the literature". Acad Emerg Med. 17 (5): 476–83. doi:10.1111/j.1553-2712.2010.00723.x. PMID 20536799. Unknown parameter |month= ignored (help)
  19. ↑ Hayward, G.; Thompson, MJ.; Perera, R.; Glasziou, PP.; Del Mar, CB.; Heneghan, CJ. (2012). "Corticosteroids as standalone or add-on treatment for sore throat". Cochrane Database Syst Rev. 10: CD008268. doi:10.1002/14651858.CD008268.pub2. PMID 23076943.

Template:WH Template:WS

Retrieved from "https://www.wikidoc.org/index.php?title=Pharyngitis_medical_therapy&oldid=934482"