View source for Pharyngitis

{{Short description|Inflammation of the back of the throat}}
{{distinguish|laryngitis}}
{{Infobox medical condition (new)
| name = Pharyngitis
| synonyms = Acute sore throat
| image = Pharyngitis.jpg
| caption = Viral pharyngitis resulting in visible redness
| field = [[Infectious disease (medical specialty)|Infectious disease]], [[family medicine]], [[otorhinolaryngology]]
| pronounce = {{IPAc-en|f|ær|ᵻ|n|ˈ|dʒ|aɪ|t|ᵻ|s}}
| symptoms = [[Sore throat]], [[fever]], runny nose, [[cough]], headache, [[hoarse voice]]<ref name=Rut2015/><ref name=EB2015/>
| complications = [[Sinusitis]], [[acute otitis media]]<ref name=EB2015/>
| onset = 
| duration = 3–10 days, depending on cause<ref name=EB2015/><ref name=Tor2011/>
| types = 
| causes = Usually [[viral infection]]<ref name=EB2015/>
| risks = 
| diagnosis = Based on symptoms, [[rapid antigen detection test]], [[throat swab]]<ref name=EB2015/>
| differential = [[Epiglottitis]], [[thyroiditis]], [[retropharyngeal abscess]]<ref name=EB2015/>
| prevention = 
| treatment = [[lidocaine]]<ref name=EB2015/><ref name=Web2014/>
| medication = 
| prognosis = 
| frequency = ~7.5% of people in any 3-month period<ref name=Jones2016/>
| deaths = 
}}
<!-- Definition and symptoms -->
'''Pharyngitis''' is [[inflammation]] of the back of the [[throat]], known as the [[pharynx]].<ref name=EB2015/> It typically results in a [[sore throat]] and [[fever]].<ref name=EB2015/> Other symptoms may include a [[Rhinorrhea|runny nose]], [[cough]], [[headache]], difficulty swallowing, swollen [[lymph node]]s, and a [[hoarse voice]].<ref name=Rut2015/><ref>{{Cite book|title=Oral and maxillofacial pathology|url=https://www.clinicalkey.com/dura/browse/bookChapter/3-s2.0-C20110077025|url-access=subscription|publisher=Elsevier|last1=Neville|first=Brad W.|last2=Damm|first2=Douglas D.|last3=Allen|first3=Carl M.|last4=Chi|first4=Angela C.|year=2016|isbn=978-1-4557-7052-6|edition=4th|location=St. Louis, MO|pages=166|oclc=908336985|access-date=17 March 2020|archive-date=28 October 2021|archive-url=https://web.archive.org/web/20211028081814/https://www.clinicalkey.com/ui-origin/master-1586/2-bundle.js}}</ref> Symptoms usually last 3–5 days, but can be longer depending on cause.<ref name=EB2015/><ref name=Tor2011>{{cite book |editor1=David A.Warrell |editor2=Timothy M. Cox |editor3=John D. Firth |editor24=Estée Török |title=Oxford textbook of medicine infection |date=2012|publisher=Oxford University Press |location=Oxford|isbn=978-0-19-163173-3 |pages=280–281|url=https://books.google.com/books?id=qkLibW2ZikYC&pg=PA280|url-status=live |archive-url=https://web.archive.org/web/20161010214543/https://books.google.com/books?id=qkLibW2ZikYC&pg=PA280|archive-date=2016-10-10}}</ref> Complications can include [[sinusitis]] and [[acute otitis media]].<ref name=EB2015/> Pharyngitis is a type of [[upper respiratory tract infection]].<ref>{{cite web|title=Pharyngitis|url=https://www.nlm.nih.gov/cgi/mesh/2016/MB_cgi?mode=&term=Pharyngitis&field=entry#TreeC08.730.561|website=National Library of Medicine|access-date=4 August 2016|archive-url=https://web.archive.org/web/20160520133301/http://www.nlm.nih.gov/cgi/mesh/2016/MB_cgi?mode=&term=Pharyngitis&field=entry#TreeC08.730.561|archive-date=20 May 2016}}</ref>

<!-- Cause and diagnosis -->
Most cases are caused by a [[viral infection]].<ref name=EB2015/> [[Strep throat]], a [[bacterial infection]], is the cause in about 25% of children and 10% of adults.<ref name=EB2015/> Uncommon causes include other bacteria such as ''[[gonococcus]]'', [[fungi]], irritants such as [[smoke]], [[allergies]], and [[gastroesophageal reflux disease]].<ref name=EB2015/><ref name=Web2014/> Specific testing is not recommended in people who have clear symptoms of a viral infection, such as a [[common cold|cold]].<ref name=EB2015/> Otherwise, a [[rapid antigen detection test]] or [[throat swab]] is recommended.<ref name=EB2015/> [[Polymerase chain reaction#Infectious disease applications|PCR]] testing has become common as it is as good as taking a throat swab but gives a faster result.<ref name="BMJBestPractice2022">{{cite web |title=Acute pharyngitis - Symptoms, diagnosis and treatment {{!}} BMJ Best Practice |url=https://bestpractice.bmj.com/topics/en-gb/5?gclid=Cj0KCQiA14WdBhD8ARIsANao07gHoxGoevNSlX5KuGk4-CmaYA3lhsFfKw8rQvaxK5Uvhj1caPOysYsaAiivEALw_wcB |website=bestpractice.bmj.com}}</ref> Other conditions that can produce similar symptoms include [[epiglottitis]], [[thyroiditis]], [[retropharyngeal abscess]], and occasionally [[heart disease]].<ref name=EB2015>{{cite journal|last1=Hildreth|first1=AF|last2=Takhar|first2=S|last3=Clark|first3=MA|last4=Hatten|first4=B|title=Evidence-Based Evaluation And Management Of Patients With Pharyngitis In The Emergency Department.|journal=Emergency Medicine Practice|date=September 2015|volume=17|issue=9|pages=1–16; quiz 16–7|pmid=26276908}}</ref>

<!-- Prevention and treatment -->
[[NSAIDs]], such as [[ibuprofen]], can be used to help with the pain.<ref name=EB2015/> Numbing medication, such as topical [[lidocaine]], may also help.<ref name=Web2014/> Strep throat is typically treated with [[antibiotic]]s, such as either [[penicillin]] or [[amoxicillin]].<ref name=EB2015/> It is unclear whether [[corticosteroids|steroids]] are useful in acute pharyngitis, other than possibly in severe cases. A recent (2020) review found that when used in combination with antibiotics, they moderately reduced pain and the likelihood of resolution.<ref name="ReferenceA">{{cite journal|last1=Principi|first1=N|last2=Bianchini|first2=S|last3=Baggi|first3=E|last4=Esposito|first4=S|title=No evidence for the effectiveness of systemic corticosteroids in acute pharyngitis, community-acquired pneumonia and acute otitis media.|journal=European Journal of Clinical Microbiology & Infectious Diseases|date=February 2013|volume=32|issue=2|pages=151–60|pmid=22993127|doi=10.1007/s10096-012-1747-y|pmc=7087613}}</ref><ref name=":0">{{Cite journal|last1=de Cassan|first1=Simone|last2=Thompson|first2=Matthew J.|last3=Perera|first3=Rafael|last4=Glasziou|first4=Paul P.|last5=Del Mar|first5=Chris B.|last6=Heneghan|first6=Carl J.|last7=Hayward|first7=Gail|date=1 May 2020|title=Corticosteroids as standalone or add-on treatment for sore throat|journal=The Cochrane Database of Systematic Reviews|volume=2020|issue=5|article-number=CD008268|doi=10.1002/14651858.CD008268.pub3|issn=1469-493X|pmc=7193118|pmid=32356360}}</ref>

<!-- Epidemiology, society and culture -->
About 7.5% of people have a sore throat in any 3-month period.<ref name=Jones2016>{{cite book|last1=Jones|first1=Roger|title=Oxford Textbook of Primary Medical Care|date=2004|publisher=Oxford University Press|isbn=978-0-19-856782-0|page=674|url=https://books.google.com/books?id=2LB0PC17uFsC&pg=PA674|access-date=4 August 2016|language=en}}</ref> Two or three episodes in a year are not uncommon.<ref name=Rut2015>{{cite book|last1=Rutter|first1=Paul Professor|last2=Newby|first2=David|title=Community Pharmacy ANZ: Symptoms, Diagnosis and Treatment|date=2015|publisher=Elsevier Health Sciences|isbn=978-0-7295-8345-9|page=19|url=https://books.google.com/books?id=NbjVCgAAQBAJ&pg=PA19|language=en|url-status=live|archive-url=https://web.archive.org/web/20170908192747/https://books.google.com/books?id=NbjVCgAAQBAJ&pg=PA19|archive-date=8 September 2017}}</ref> This resulted in 15 million physician visits in the United States in 2007.<ref name=Web2014>{{cite journal|last1=Weber|first1=R|title=Pharyngitis.|journal=Primary Care|date=March 2014|volume=41|issue=1|pages=91–8|pmid=24439883|doi=10.1016/j.pop.2013.10.010|pmc=7119355}}</ref> Pharyngitis is the most common cause of a sore throat.<ref name=Rosen2010>{{cite book |title=Rosen's emergency medicine: concepts and clinical practice |edition=7th |last=Marx |first=John |year=2010 |publisher=Mosby/Elsevier |location=Philadelphia, Pennsylvania |isbn=978-0-323-05472-0 |at=Chapter 30 }}</ref> The word comes from the [[Classical language|Greek word]] ''pharynx'' meaning "throat" and the suffix ''-itis'' meaning "inflammation".<ref>{{cite book|last1=Beachey|first1=Will|title=Respiratory Care Anatomy and Physiology, Foundations for Clinical Practice,3: Respiratory Care Anatomy and Physiology|date=2013|publisher=Elsevier Health Sciences|isbn=978-0-323-07866-5|page=5|url=https://books.google.com/books?id=LBzD30OmrSwC&pg=PA5|language=en|url-status=live|archive-url=https://web.archive.org/web/20170908192747/https://books.google.com/books?id=LBzD30OmrSwC&pg=PA5|archive-date=8 September 2017}}</ref><ref>{{cite book|last1=Hegner|first1=Barbara|last2=Acello|first2=Barbara|last3=Caldwell|first3=Esther|title=Nursing Assistant: A Nursing Process Approach – Basics|date=2009|publisher=Cengage Learning|isbn=978-1-111-78050-0|page=45|url=https://books.google.com/books?id=LopsCgAAQBAJ&pg=PA45|language=en|url-status=live|archive-url=https://web.archive.org/web/20170908192747/https://books.google.com/books?id=LopsCgAAQBAJ&pg=PA45|archive-date=8 September 2017}}</ref>
{{TOC limit}}

==Classification==
[[File:Amigdalas (cropped).jpg|thumb|A normal throat]]
Pharyngitis is a type of inflammation caused by an [[upper respiratory tract infection]]. It may be classified as acute or chronic. Acute pharyngitis may be [[catarrh]]al, [[purulent]], or [[Ulcer (dermatology)|ulcerative]], depending on the [[causative agent]] and the [[Immunity (medical)|immune capacity]] of the affected individual. Chronic pharyngitis may be catarrhal, [[Hypertrophy|hypertrophic]], or [[Atrophy|atrophic]].{{citation needed|date=August 2020}}

[[Tonsillitis]] is a subtype of pharyngitis.<ref>{{cite web|title=Tonsillitis|url=https://meshb.nlm.nih.gov/#/record/ui?ui=D014069|access-date=4 August 2016|url-status=live|archive-url=https://web.archive.org/web/20160325080921/http://www.nlm.nih.gov/cgi/mesh/2016/MB_cgi?field=uid&term=D014069|archive-date=25 March 2016}}</ref> If the inflammation includes both the [[tonsil]]s and other parts of the throat, it may be called '''pharyngotonsillitis''' or '''tonsillopharyngitis'''.<ref name=Ped2006>{{cite journal |vauthors=Rafei K, Lichenstein R | title = Airway Infectious Disease Emergencies | journal = Pediatric Clinics of North America | volume = 53 | issue = 2 | pages = 215–242 | year = 2006 | pmid = 16574523 | doi = 10.1016/j.pcl.2005.10.001 }}</ref> Another subclassification is [[nasopharyngitis]] (the common cold).<ref>{{cite web |url=https://meshb.nlm.nih.gov/#/record/ui?ui=D014069 |title=www.nlm.nih.gov |url-status=live |archive-url=https://web.archive.org/web/20151117014738/http://www.nlm.nih.gov/cgi/mesh/2010/MB_cgi?field=uid&term=D014069 |archive-date=17 November 2015 }}</ref>

'''Clergyman's sore throat''' or '''clergyman's throat''' is an archaic term formerly used for chronic pharyngitis associated with overuse of the voice as in public speaking. It was sometimes called ''dysphonia clericorum'' or chronic [[folliculitis]] sore throat.<ref>{{Cite journal |last=Broadwater |first=Kimberly |date=2021 |title=Clergyman's Sore Throat |url=https://muse.jhu.edu/article/803425 |journal=Journal of Singing |volume=78 |issue=1 |pages=113–117 |doi=10.53830/CNLB1302 |s2cid=239663449 |issn=2769-4046|url-access=subscription }}</ref>

==Cause==
Most cases are due to an [[infectious organism]] acquired from close contact with an infected individual.{{citation needed|date=August 2020}}

===Viral===
[[File:Mononucleosis.JPG|thumb|left|[[Exudative]] pharyngitis in a person with [[infectious mononucleosis]]]]
These comprise about 40–80% of all infectious cases and can be a feature of many different types of viral infections.<ref name=Rosen2010/><ref name="Acerra">{{cite web |url=http://emedicine.medscape.com/article/764304-overview |title=Pharyngitis |author=Acerra JR |work=eMedicine |access-date=28 April 2010 |url-status=live |archive-url=https://web.archive.org/web/20100317130804/http://emedicine.medscape.com/article/764304-overview |archive-date=17 March 2010 }}</ref>

*[[Adenovirus]] is the most common of the viral causes. Typically, the degree of neck [[lymph node]] enlargement is modest, and the throat often does not appear red, although it is painful.
*The family ''[[Orthomyxoviridae]]'' which causes [[influenza]] presents with rapid-onset high temperature, headache, and generalized ache. A sore throat may be associated.
*[[Infectious mononucleosis]] ("glandular fever") is caused by the [[Epstein–Barr virus]]. This may cause significant lymph-node swelling and an [[exudative]] tonsillitis with marked redness and swelling of the throat. The [[heterophile test]] can be used if this is suspected.
*[[Herpes simplex virus]] can cause multiple [[mouth ulcer]]s.
*[[Measles]]
*[[Common cold]]: [[rhinovirus]], [[coronavirus]], [[respiratory syncytial virus]], and [[parainfluenza virus]] can cause infection of the throat, ear, and lungs, causing standard cold-like symptoms and often pain.

===Bacterial===
Several bacteria can infect the human throat. The most common is [[group A streptococcus]] (''[[Streptococcus pyogenes]]''), but others include ''[[Streptococcus pneumoniae]]'', ''[[Haemophilus influenzae]]'', ''[[Bordetella pertussis]]'', ''[[Bacillus anthracis]]'', ''[[Corynebacterium diphtheriae]]'', ''[[Neisseria gonorrhoeae]]'', ''[[Chlamydophila pneumoniae]]'', ''[[Mycoplasma pneumoniae]],'' and ''[[Fusobacterium necrophorum]]''.<ref name=NEJM2001>{{cite journal | author = Bisno AL | title = Acute pharyngitis | journal = [[N Engl J Med]] | volume = 344 | issue = 3 | pages = 205–11 | date = January 2001 | pmid = 11172144 | doi = 10.1056/NEJM200101183440308 }}</ref>

====Streptococcal pharyngitis====
{{Main|Streptococcal pharyngitis}}[[File:Pos strep.JPG|thumb|A case of strep throat]]
Streptococcal pharyngitis or strep throat is caused by a [[group A beta-hemolytic streptococcus]] (GAS).<ref name=Review10>{{cite journal | author = Baltimore RS | title = Re-evaluation of antibiotic treatment of streptococcal pharyngitis | journal = Curr. Opin. Pediatr. | volume = 22 | issue = 1 | pages = 77–82 | date = February 2010 | pmid = 19996970 | doi = 10.1097/MOP.0b013e32833502e7 | s2cid = 13141765 }}</ref> It is the most common bacterial cause of cases of pharyngitis (15–30%).<ref name=NEJM2001/> Common symptoms include [[fever]], [[sore throat]], and large lymph nodes. It is a contagious infection that is spread by close contact with an infected individual. A definitive diagnosis is made based on the results of a [[throat culture]]. [[Antibiotics]] are useful to both prevent complications (such as [[rheumatic fever]]) and speed recovery.<ref name=Review09>{{cite journal | author = Choby BA | title = Diagnosis and treatment of streptococcal pharyngitis | journal = Am Fam Physician | volume = 79 | issue = 5 | pages = 383–90 | date = March 2009 | pmid = 19275067 | url = http://www.aafp.org/afp/2009/0301/p383.html | url-status = live | archive-url = https://web.archive.org/web/20150208124744/http://www.aafp.org/afp/2009/0301/p383.html | archive-date = 8 February 2015 }}</ref>

====Fusobacterium necrophorum====
''[[Fusobacterium necrophorum]]'' is a normal inhabitant of the oropharyngeal [[Bacterial flora|flora]] and can occasionally create a [[peritonsillar abscess]]. In one out of 400 untreated cases, [[Lemierre's syndrome]] occurs.<ref>{{cite journal | author = Centor RM | title = Expand the pharyngitis paradigm for adolescents and young adults | journal = [[Ann Intern Med]] | volume = 151 | issue = 11 | pages = 812–5 | date = 1 December 2009 | pmid = 19949147 | doi = 10.7326/0003-4819-151-11-200912010-00011 | citeseerx = 10.1.1.669.7473 | s2cid = 207535809 }}</ref>

====Diphtheria====
[[Diphtheria]] is a potentially life-threatening upper respiratory infection caused by ''[[Corynebacterium diphtheriae]]'', which has been largely eradicated in developed nations since the introduction of childhood [[vaccination]] programs, but is still reported in the [[Third World]] and increasingly in some areas in [[Eastern Europe]]. Antibiotics are effective in the early stages, but recovery is generally slow.{{Citation needed|date=April 2009}}

====Others====
A few other causes are rare, but possibly fatal, and include [[parapharyngeal space]] infections: [[peritonsillar abscess]] ("quinsy abscess"), [[submandibular space infection]] (Ludwig's angina), and [[epiglottitis]].<ref>{{cite web |url=http://www.uptodate.com/online/content/topic.do?topicKey=pc_id/4421&selectedTitle=1~150&source=search_result |title=UpToDate Inc. |url-status=live |archive-url=https://web.archive.org/web/20090627030426/http://www.uptodate.com/online/content/topic.do?topicKey=pc_id%2F4421&selectedTitle=1~150&source=search_result |archive-date=27 June 2009 }} (registration required)</ref><ref>{{cite journal |vauthors=Reynolds SC, Chow AW | title = Severe soft tissue infections of the head and neck: a primer for critical care physicians | journal = [[Lung (journal)|Lung]] | volume = 187 | issue = 5 | pages = 271–9 | date = Sep–Oct 2009 | pmid = 19653038 | doi = 10.1007/s00408-009-9153-7 | s2cid = 9009912 }}</ref><ref>{{cite journal |vauthors=Bansal A, Miskoff J, Lis RJ | title = Otolaryngologic critical care | journal = [[Crit Care Clin]] | volume = 19 | issue = 1 | pages = 55–72 | date = January 2003 | pmid = 12688577 | doi = 10.1016/S0749-0704(02)00062-3 }}</ref>

===Fungal===
Some cases of pharyngitis are caused by [[Fungal infection in animals|fungal infection]], such as ''[[Candida albicans]]'', causing [[Oral candidiasis|oral thrush]].<ref>{{cite web |last1=Harvard Medical School |title=Sore Throat (Pharyngitis) |url=https://www.health.harvard.edu/a_to_z/sore-throat-pharyngitis-a-to-z |website=Harvard Health Publishing Harvard Medical School |publisher=Harvard Health Publishing |access-date=3 December 2019}}</ref>

===Noninfectious===
Pharyngitis may also be caused by mechanical, chemical, or thermal irritation, for example, cold air or [[acid reflux]]. Some medications may produce pharyngitis, such as [[pramipexole]] and [[antipsychotic]]s.<ref>{{cite web |url=http://bidocs.boehringer-ingelheim.com/BIWebAccess/ViewServlet.ser?docBase=renetnt&folderPath=/Prescribing+Information/PIs/Mirapex/Mirapex.pdf |title=Mirapex product insert |year=2009 |publisher=Boehringer Ingelheim |access-date=30 June 2010 |url-status=live |archive-url=https://web.archive.org/web/20100614020208/http://bidocs.boehringer-ingelheim.com/BIWebAccess/ViewServlet.ser?docBase=renetnt&folderPath=%2FPrescribing+Information%2FPIs%2FMirapex%2FMirapex.pdf |archive-date=14 June 2010 }}</ref><ref>{{cite web |url=http://medical-dictionary.thefreedictionary.com/olanzapine |title=Mosby's Medical Dictionary, 8th edition  |year=2009 |publisher=Elsevier |access-date=30 June 2010}}</ref>

==Diagnosis==
{| class="wikitable" style = "float: right; margin-left:15px; text-align:center"
|+ Modified Centor score
!Points||Probability of Strep||Management
|-
| 1 or less|| <10%||No antibiotic or culture needed
|-
| 2        ||11–17%||rowspan="2"|Antibiotic based on culture or [[rapid antigen detection test]]
|-
| 3        ||28–35%
|-
| 4 or 5   ||52%||[[Empiric antibiotics]]
|}
[[File:Throat Culture.png|thumbnail|Throat swab]]
Differentiating a viral and a bacterial cause of a sore throat based on symptoms alone is difficult.<ref name=IDSA2012/> Thus, a throat swab often is done to rule out a bacterial cause.<ref name="pmid1565052">{{cite journal | author = Del Mar C | title = Managing sore throat: a literature review. I. Making the diagnosis | journal = [[Medical Journal of Australia]] | volume = 156 | issue = 8 | pages = 572–5 | year = 1992 | pmid = 1565052 | doi =  10.5694/j.1326-5377.1992.tb121422.x}}</ref>

The modified [[Centor criteria]] may be used to determine the management of people with pharyngitis. Based on five clinical criteria, it indicates the probability of a streptococcal infection.<ref name=Review09/>

One point is given for each of the criteria:<ref name=Review09/>
* Absence of a cough
* Swollen and tender [[cervical lymph nodes]]
* Temperature more than {{convert|38.0|C|F}}
* Tonsillar exudate or swelling
* Age less than 15 (a point is subtracted if age is more than 44)

The [[Infectious Disease Society of America]] recommends against [[empirical treatment]] and considers antibiotics only appropriate following positive testing.<ref name="IDSA2012" /> Testing is not needed in children under three, as both group A strep and [[rheumatic fever]] are rare, except if they have a sibling with the disease.<ref name="IDSA2012">{{cite journal |vauthors=Shulman ST, Bisno AL, Clegg HW, Gerber MA, Kaplan EL, Lee G, Martin JM, Van Beneden C | title = Clinical Practice Guideline for the Diagnosis and Management of Group A Streptococcal Pharyngitis: 2012 Update by the Infectious Diseases Society of America. | journal = Clinical Infectious Diseases | volume = 55 | issue = 10 | pages = e86–102 | date = 9 September 2012 | pmid = 22965026 | doi = 10.1093/cid/cis629 | pmc = 7108032 | doi-access = free }}</ref>

==Management==
The majority of the time, treatment is symptomatic. Specific treatments are effective for bacterial, fungal, and [[herpes simplex]] infections.

===Medications===
* [[Analgesics|Pain medication]], such as [[NSAIDs]] and [[Paracetamol|acetaminophen (paracetamol)]], can help reduce the pain associated with a sore throat. Aspirin may be used in adults, but is not recommended in children due to the risk of [[Reye syndrome]].<ref>{{cite journal|title=Re-evaluation of antibiotic treatment of streptococcal pharyngitis|date=February 2010|issue=Curr. Opin. Pediatr. 22 (1)|pages=77–82|doi=10.1097/MOP.0b013e32833502e7|pmid=19996970|volume=22|author=Baltimore RS|journal=Current Opinion in Pediatrics|s2cid=13141765}}</ref>
* [[Steroid]]s (such as [[dexamethasone]]) may be useful for severe pharyngitis.<ref>{{cite journal |vauthors=Hayward G, Thompson M, Heneghan C, Perera R, Del Mar C, Glasziou P | title = Corticosteroids for pain relief in sore throat: systematic review and meta-analysis | journal = BMJ | volume = 339 | article-number = b2976 | year = 2009 | pmid = 19661138 | pmc = 2722696 | doi = 10.1136/bmj.b2976 }}</ref><ref name=":0" /> Their general use, however, is poorly supported.<ref name="ReferenceA"/>
* Viscous [[lidocaine]] relieves pain by numbing the mucous membranes.<ref>{{cite web |url=http://www.medicinenet.com/lidocaine_viscous/article.htm |title=LIDOCAINE VISCOUS (Xylocaine Viscous) side effects, medical uses, and drug interactions. |url-status=live |archive-url=https://web.archive.org/web/20100408065631/http://www.medicinenet.com/lidocaine_viscous/article.htm |archive-date=8 April 2010 }}</ref>
* [[Antibiotic]]s are useful if a bacterial infection is the cause of the sore throat.<ref>{{cite journal|last1=Kocher|first1=JJ|last2=Selby|first2=TD|title=Antibiotics for sore throat.|journal=American Family Physician|date=1 July 2014|volume=90|issue=1|pages=23–4|pmid=25077497}}</ref><ref>{{Cite journal |last1=Spinks |first1=Anneliese |last2=Glasziou |first2=Paul P. |last3=Del Mar |first3=Chris B. |date=2021-12-09 |title=Antibiotics for treatment of sore throat in children and adults |url= |journal=The Cochrane Database of Systematic Reviews |volume=2021 |issue=12 |article-number=CD000023 |doi=10.1002/14651858.CD000023.pub5 |issn=1469-493X |pmc=8655103 |pmid=34881426}}</ref> For viral infections, antibiotics have no effect. In the United States, they are used in 25% of people before a bacterial infection has been detected.<ref>{{cite journal|last1=Urkin|first1=J|last2=Allenbogen|first2=M|last3=Friger|first3=M|last4=Vinker|first4=S|last5=Reuveni|first5=H|last6=Elahayani|first6=A|title=Acute pharyngitis: low adherence to guidelines highlights need for greater flexibility in managing paediatric cases.|journal=Acta Paediatrica|date=November 2013|volume=102|issue=11|pages=1075–80|pmid=23879261|doi=10.1111/apa.12364|s2cid=24465793}}</ref>
* Oral analgesic solutions, the active ingredient is usually [[phenol]], but also less commonly [[benzocaine]], [[cetylpyridinium chloride]], and/or [[menthol]]. [[Chloraseptic]] and [[Cēpacol|Cepacol]] are two examples of brands of these kinds of analgesics.{{citation needed|date=August 2020}}

===Alternative===
{{see also|Alternative treatments used for the common cold}}
Gargling [[salt water]] is often suggested, but there is no evidence to support or discourage this practice.<ref name=Web2014/> [[Alternative medicines]] are promoted and used for the treatment of sore throats.<ref name="mayo"/> However, they are poorly supported by evidence.<ref name="mayo">{{cite web |url=http://www.mayoclinic.com/health/sore-throat/DS00526/DSECTION=10 |title=Sore throat: Self-care |publisher=[[Mayo Clinic]] |access-date=17 September 2007 |url-status=live |archive-url=https://web.archive.org/web/20070929153814/http://www.mayoclinic.com/health/sore-throat/DS00526/DSECTION%3D10 |archive-date=29 September 2007 }}</ref>
<!--Please include appropriate reference if found for: a peer-reviewed study or verifiable documentation regarding the effects of [[gargling]] with warm salt water. Comment: The Mayo Clinic says they are used but not effective. ... Reply from CyclePat: I can't find this in at the reference provided (for the gargling). I will look into it again though.  It is hear but I do not think this is a good enough ref http://www.mayoclinic.com/health/sore-throat/DS00526/DSECTION=lifestyle-and-home-remedies -->

==Epidemiology==
Acute pharyngitis is the most common cause of a [[sore throat]] and, together with cough, it is diagnosed in more than 1.9 million people a year in the United States.<ref name="Rosen2010"/>

==References==
{{Reflist}}

{{Medical resources
| DiseasesDB      = 24580
| ICD11           = {{ICD11|CA02}}, {{ICD11|CA09.2}}
| ICD10           = {{ICD10|J|02||j|00}}, {{ICD10|J|31|2|j|30}}
| ICD9            = {{ICD9|462}}, {{ICD9|472.1}}
| ICDO            =
| OMIM            =
| MedlinePlus     = 000655
| eMedicineSubj   = emerg
| eMedicineTopic  = 419
| MeshID          = D010612
}}
{{Respiratory pathology}}
{{Common cold}}
{{Subject bar|Medicine|auto=1}}
{{Use dmy dates|date=April 2018}}

[[Category:Infectious diseases]]
[[Category:Inflammations]]
[[Category:Upper respiratory tract diseases]]
[[Category:Gastrointestinal tract disorders]]
[[Category:Wikipedia medicine articles ready to translate]]
[[Category:Pharynx]]
[[Category:Wikipedia emergency medicine articles ready to translate]]
[[Category:Otorhinolaryngology]]