Sore throats result from viral infections in ~70% of cases. Manage them with symptom-relief measures such as saltwater gargles (1/2 tsp salt in 8 oz warm water, 2–3 times daily), throat lozenges containing benzocaine or menthol, and pain relievers like acetaminophen (500 mg every 4 hours, max 3,000 mg/day) or ibuprofen (400 mg every 4–6 hours as needed). For bacterial pharyngitis (e.g., strep throat), prescription antibiotics such as penicillin or amoxicillin are necessary, with corticosteroids reserved for severe swelling under medical supervision.
January 11, 2025

Sore Throat: At-Home Management

Evidence-Based Over-The-Counter Guide

William Shen

William Shen

Co-founder & CPO

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Sore throat (pharyngitis) is a common condition often caused by viral (70% of cases) or bacterial infections, environmental irritants, or allergens. Treatment is aimed at symptom relief and addressing the underlying cause. 

The main worrisome complication is a peritonsillar abscess or systemic spread in the case of a bacterial infection. If you notice throat swelling or trouble breathing, seek immediate medical attention.

First-line Recommendations:

  • Salt Water Gargle: Reduces inflammation and relieves irritation. Dose: Gargle with warm saline upon waking up and (1/2 tsp salt in 8 oz water) 2-3 times daily. 

  • Throat Lozenges: Contain soothing agents like benzocaine and menthol to ease discomfort. Use as needed. Chloraseptic product (FDA M022).

  • Painkillers as needed: Acetaminophen (FDA M013) 500 mg orally every 4 hours (max. dose 3,000 mg/24 hours) or ibuprofen (FDA N021472) 400 mg PO every 4–6 hours as needed.

Prescription Medications:

  • Antibiotics (e.g., Penicillin, Amoxicillin): For confirmed bacterial pharyngitis such as Streptococcal throat. Dose and duration as prescribed by a healthcare provider.

  • Corticosteroids: For severe inflammation or swelling causing difficulty swallowing. Requires medical supervision.

Citations:

Shulman et al. Clinical Practice Guideline for the Diagnosis and Management of Group A Streptococcal Pharyngitis: 2012 Update by the Infectious Diseases Society of America. Clinical Infectious Diseases. 2012; 55(10): p.e86–e102. doi: 10.1093/cid/cis629

Ramalingam, S., Graham, C., Dove, J., Morrice, L., & Sheikh, A. (2019). A pilot, open labelled, randomised controlled trial of hypertonic saline nasal irrigation and gargling for the common cold. Scientific reports, 9(1), 1015. https://doi.org/10.1038/s41598-018-37703-3

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