Pharyngitis (Sore Throat)

Introduction

Pharyngitis which is commonly known as sore throat is an inflammation of the pharynx, resulting in a sore throat.
It is a common cause of persistent sore throat in young and most middle-aged adults, usually unaccompanied by other symptoms.

It is often secondary to chronic nasal conditions with nasal obstruction e.g.

  • Vasomotor rhinitis
  • Nasal polyps
  • Septal deviation.

Obstruction causes mouth breathing with dryness of the throat
Other causes:

  • Secondary inflammation from postnasal discharge of sinusitis
  • Chronic exposure to irritants such as tobacco smoke and alcohol.
  • Secondary infection from carious teeth 

Symptoms and Clinical features of Pharyngitis (Sore Throat)

  • Persistent sore throat with no systemic upset or dysphagia
  • Sore throat is often worse in the mornings.

Differential diagnoses

  • Chronic tonsillitis
  • Pharyngeal or laryngeal tumour

Complications of Pharyngitis (Sore Throat)

  • More often related to the primary sources of irritation or infection

Investigations

  • Throat swab: microscopy, culture and sensitivity
  • X-ray of paranasal sinuses

Treatment for Pharyngitis (Sore Throat)

Treatment objectives

  • Control symptoms by identifying and treating primary causes

Non-drug treatment

  1. Treat sinusitis
  2. Surgery for obstructive nasal conditions
  3. Treat dental caries

Drug treatment

  1. Appropriate antibacterial agent if indicated
  2. Supportive measures
  3. Reduction or avoidance of exposure to known irritants-tobacco, alcohol, etc

B: azithromycin (PO)
Adults: 500mg 24hourly for 3days.
Children: 10mg/kg 24hourly for 3days

OR

B: amoxicillin+ clavulanic acid (PO)(FDC)
Adults: 625mg 8hourly for 7days
Children: 375mg 12hourly for 7days;

OR

C: clarithromycin (PO),
Adults: 500mg 12 hourly for 7-14days.
Children 2 – 6 months: 15mg/kg/day in 2 divided doses for 7-14days

OR

S: cefixime (PO)
Adults: 400mg 24 hourly for 7-14days.
Children ≥ 6 months to 12 years (weight below 45kg): 8mg/kg 24hourly for 7-14days

AND

A: paracetamol (PO)
Adult 1gm 10mg/ kg body weight 8 hourly until the fever is controlled

OR

A: ibuprofen (PO)
Adults: 200-400mg 4-8hourly as needed.
Children 2 – 6 months: 5 – 10mg/kg 4-8hourly as needed

OR

A: diclofenac (IM)
Adults 75 mg 8hourly as needed

OR

C: diclofenac (PO)
Adults: 50 mg 4-8hourly as needed

OR

C: diclofenac+ paracetamol (PO) (FDC)
Adults: 50mg diclofenac and 500mg paracetamol 4-8hourly as needed.