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What's the best sore throat medicine to use?

Medically reviewed by Drugs.com Last updated on Sep 6, 2018.

Official Answer

by Drugs.com

Sore throats are common. Most are caused by viruses, but throats can also become sore as a result of smoking, allergies, air irritants (such as pollution, air conditioning), or yelling too much. Sometimes sore throats are caused by bacteria, or bacteria take advantage of the fact that your immune system is already under pressure, and colonize an already existing viral sore throat. Sore throats with bacterial involvement are more serious than sore throats due to most other causes. Bacterial sore throats need a doctor's involvement, whereas the majority of sore throats caused by other conditions get better by themselves.

How do I know if my sore throat is caused by bacteria?

You don't unless a doctor has taken a throat swab and sent it away to the lab for culture. But there are a few clues to look for that can help you decide if your sore throat is more likely to be caused by a virus or a less serious cause such as an allergy or an irritant, or more likely to be caused by bacteria.

Viral sore throats are generally accompanied by cold symptoms, such as a runny nose, watery eyes, or a cough. Symptoms such as sneezing, red eyes, or an itchy roof of the mouth usually accompany sore throats caused by an allergy. Sore throats caused by pollutants generally get better once the cause has been eliminated whether it be smoking or bad air.

Bacterial sore throats tend to come on quickly and are more likely to affect children aged between five and fifteen rather than adults. A type of bacteria called Streptococcus pyrogenes (often referred to as a Strep Throat) is the most common cause of bacterial sore throats. People living in overcrowded environments such as boarding schools, military camps, or in damp homes are more at risk and the condition is more prevalent between November and April. Strep throat is very contagious and can be passed on from person to person by coughing, sneezing and close contact. Very rarely, the bacteria may be passed on through food. If somebody in your household has a Strep throat, there is a one in four chance you may also get it within two to seven days.

Strep throats also tend to be described as a very severe sore throat, and symptoms persist for a lot longer than sore throats due to another cause. Swallowing may be particularly difficult, and the tonsils and back of the throat appear bright red and swollen-looking. Sometimes streaks of pus or red spots on the roof of the mouth are visible. Other symptoms such as fever and a headache may occur and the lymph nodes in the neck may be swollen and tender. Children may also feel nauseous or vomit.

If you are even slightly suspicious that either you or a child may have a Strep throat, seek medical attention straight away. Most people fully recover if given antibiotics soon after infection. But if left untreated, Strep throat can lead to otitis media (ear infections), Scarlet fever (symptoms include a bright red rash that feels like sandpaper to the touch), Rheumatic fever (an inflammatory disease that can cause permanent heart damage and also affect the brain, joints and skin), blood poisoning, kidney disease, and bone infections. People with strep throat or scarlet fever should stay home for at least 24 hours after starting antibiotics or until they feel well enough to return to school or work.

How do you cure a sore throat?

Most sore throats have to run their course, so sore throat medicine can only temporarily relieve the symptoms, until the cause (be it viral, bacterial, allergic or environmental) is eliminated.

So what helps a sore throat? Sore throat treatments may contain either pain relievers, anesthetic agents, antibacterials, natural ingredients with soothing properties or to boost the immune system, or a combination of these agents.

Honey is a very effective sore throat treatment as it is naturally antibacterial and can draw water out of inflamed tissue, reducing swelling and discomfort. A salt water gargle (half a teaspoon of salt in one cup of warm water, gargle for 20 seconds, three times a day) is also naturally antiviral and antibacterial and good at relieving fluid build up in tissue.

The inner bark of the slippery elm tree swells on contact with water and forms a gooey substance that soothes sore throats. Licorice root has anti-inflammatory properties and marshmallow forms a protective film over the tissues of the throat. Other natural remedies that can soothe a sore throat include honeysuckle, echinacea, and zinc.

Anti-inflammatories, such as ibuprofen (Advil, Motrin), help temporarily reduce inflammation and relieve pain although are not suitable for everybody.

Acetaminophen (Actin, Tylenol) is a good alternative, although it has only pain-relieving, not anti-inflammatory, properties.

Drugstores also have plenty of options. Lozenges for sore throats contain various different types of ingredients (such as anti-inflammatories, anesthetics, antiseptics) which act directly where your throat is sore, and also help stimulate the flow of saliva, keeping your throat moist. Anesthetics numb your throat and antiseptics help reduce bacterial counts but are unlikely to prevent a Strep infection. Sprays and gargles are also available which also directly target the back of the throat. Look at the ingredient list to see what active ingredients the product contains - ask your pharmacist if you can't make any sense of it. The choice really comes down to personal preference and you may have to try several different types of products before you find the one that is most suitable for you. There is no single best sore throat medicine.

Antibiotics from a doctor are needed to treat a bacterial sore throat. See a full list of antibiotics used to treat strep throat.

Other sore throat relief

Because most sore throats are viral in origin, rest and a good healthy diet help your immune system fight the infection. Keep foods soft and drinks cool so you don't irritate your throat further. Soups provide good nourishment when eating is too difficult and lemon & honey and herbal teas contain antioxidants that are also beneficial for boosting your immune system.

If somebody I know has a sore throat, how can I reduce my risk of getting it?

The best way to prevent infection is to wash your hands often and always before eating or after being in contact with an infected person. Do not share utensils, linen, or personal items. Eat plenty of vegetables, drink 6 to 8 glasses of water each day, and limit the amount of sugar you eat and alcohol you drink. Exercise, don't smoke, and don't yell!

References
  1. Pharyngitis (Strep Throat). Revised Sep 16, 2016. Centers for Disease Control and Prevention http://www.cdc.gov/groupastrep/diseases-hcp/strep-throat.html
  2. Group A streptococcal Disease (GAS). Revised Sep 16, 2016. Centers for Disease Control and Prevention http://www.cdc.gov/groupastrep/
  3. Scarlet Fever: A Group A Streptococcal Infection. January 19, 2016. Centers for Disease Control and Prevention http://www.cdc.gov/Features/ScarletFever/
  4. Scarlet Fever. NHS Choices. Reviewed 04/03/2015. http://www.nhs.uk/Conditions/Scarlet-fever/Pages/Introduction.aspx
  5. Scarlet Fever. Updated Sept 2015. Dermnet NZ http://www.dermnetnz.org/topics/scarlet-fever/
  6. Acute Rheumatic Fever and Rheumatic Heart Disease Among Children — American Samoa, 2011–2012 Morbidity and Mortality Weekly Report. Centers for Disease Control and Prevention May 29, 2015 / 64(20);555-558
  7. Rheumatic Fever. Medline Plus. US National Library of Medicine. https://medlineplus.gov/ency/article/00394
  8. Sore throat. Home remedies. Mayo Clinic. http://www.mayoclinic.org/diseases-conditions/sore-throat/basics/lifestyle-home-remedies/con-20027360
  9. Rennard BO, Ertl RF, Gossman GL, et al. Chicken soup inhibits neutrophil chemotaxis in vitro. Chest. 2000 Oct;118(4):1150-7. http://www.ncbi.nlm.nih.gov/pubmed/11035691
  10. Sore throat. Treatment. Mayo Clinic. http://www.mayoclinic.org/diseases-conditions/sore-throat/basics/alternative-medicine/con-20027360
  11. Strep throat. Mayo Clinic. http://www.mayoclinic.org/diseases-conditions/strep-throat/basics/definition/con-20022811
  12. Live Well. Cleveland Clinic. http://my.clevelandclinic.org/health/healthy_living/hic_Steps_to_Staying_Well

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