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
- Treat sinusitis
- Surgery for obstructive nasal conditions
- Treat dental caries
Drug treatment
- Appropriate antibacterial agent if indicated
- Supportive measures
- 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.