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Pharyngitis

Updated : February 15, 2024





Background

Pharyngitis is an inflammation of the oropharynx’s mucosal surfaces. Most frequently, a viral or bacterial illness is to blame. Allergies, malignancy, trauma, reflux, and specific poisons are a few fewer common triggers of pharyngitis.

Epidemiology

692,000 of the 1.814 million pharyngitis visits to emergency rooms in 2010 involved patients under the young of fifteen. Pharyngitis most frequently affects children younger than the age of five.

Although less frequently, the illness can also emerge in adults. Pharyngitis incidence is relatively high over the world, especially in nations whereby antibiotics are overmedicated.

Anatomy

Pathophysiology

The pharyngeal mucosal can be directly invaded by viruses and bacteria. Some viruses, such as the rhinovirus, can irritate the nose as a result of nasal discharges. There is nearly always a localized invasion of the pharyngeal mucous, which also causes an overabundance of edema and discharges.

Etiology

Pharyngitis, or painful throat, symptoms are caused by a number of viral infections and are caused by 50 percent to 80 percent of cases. Mostly influenza, rhinovirus, adenovirus, parainfluenza, and coronavirus are the microorganisms that cause these illnesses. Herpes, the Epstein-Barr virus, the human immunodeficiency virus (HIV), and the coxsackievirus are less prevalent viral infections. After such a viral illness, more serious instances often turn out to be a bacterium.

Acute pharyngitis is most frequently brought on by Group A beta-hemolytic streptococcus, which accounts for 5 percent to 36percent of cases. Additional bacterial etiological factors include Candida, Arcanobacterium haemolyticum, Group B and C streptococcus, Mycoplasma pneumoniae, Chlamydia pneumoniae, Haemophilus influenzae, N. meningitides, N. gonorrhoeae, Corynebacterium diphtheriae, and Fusobacterium necrophorum.

Acute pharyngitis can also be brought on by chemical exposure and environmental allergens. Symptoms of other serious disorders, such as retropharyngeal abscess, peritonsillar abscess, Kawasaki disorder, and epiglottitis, may also include pharyngitis.

Genetics

Prognostic Factors

The outcome for pharyngitis is generally favorable because both bacterial and viral infections frequently self-limit to five to seven days. About 20 million people in underdeveloped nations contract acute rheumatic fever from group A streptococci infections.

The main factor in young people’s deaths is this disorder. Pharyngitis rarely results in death, but it can if the airway is damaged. The majority of pharyngitis cases heal in 7 to 10 days. Resistance to antibiotics, untreated close connections, and poor compliance are typically the causes of treatment failures.

Clinical History

Physical Examination

Age group

Associated comorbidity

Associated activity

Acuity of presentation

Differential Diagnoses

Laboratory Studies

Imaging Studies

Procedures

Histologic Findings

Staging

Treatment Paradigm

by Stage

by Modality

Chemotherapy

Radiation Therapy

Surgical Interventions

Hormone Therapy

Immunotherapy

Hyperthermia

Photodynamic Therapy

Stem Cell Transplant

Targeted Therapy

Palliative Care

Medication

 

cefprozil

500

mg

Tablet

Orally 

every 24 hours

10

days

If the infection is caused by S. pyrogenes, administer the dose for more than 10 days



amoxicillin 

500

mg

2 times a day or 1 g daily

10

days


ER: 775 mg daily for 10 days



penicillin v 

250

mg

orally

4 times a day

10

days



penicillin G benzathine 

1.2 million units given IM daily as a single dose



erythromycin ethylsuccinate 

400

mg

Orally 

divided in to 2 times a day

10

days



clarithromycin 

Indicated for Streptococcal pharyngitis:


250 mg oral tablet immediate release twice a day for 14 days



cephalexin 

250

mg

Capsule

Orally 

every 6 hrs



cefadroxil 

1

g

orally

daily

10

days


Note: indicated for pharyngitis and tonsillitis caused by Group A beta-hemolytic streptococci



azithromycin 

500 mg orally once a day, followed by 250 mg 4 times a day, on the 2nd to 5th day.



penicillin VK 

125 - 250

mg

Orally 

every 8 hrs

10

days



cefixime 

400 mg/day orally in single daily dose or divided every 12hr



azithromycin 

The drug treats inflammation in the pharynx and tonsils. Streptococcus pyogenes cause the infection; the dose for the same is 500 mg on the 1st day, followed by 250 mg drug four times daily on the 2nd to 5th day.



azithromycin 

Day 1: 500 mg orally in a single dosage;
Days 2–5: 250 mg orally per day



benzocaine oropharyngeal 

Spray onto the oral mucosa with an oral sprayer for approximately 0.5 seconds; repeat for four times daily.
Allow the lozenge to melt gently in the mouth; repeat for every two hours as needed.



dyclonine/menthol 

Indicated for Pharyngitis & Cough
Allow gradual dissolution of the lozenge in the oral cavity
can be repeated every two hours as needed
Ensure the total daily consumption does not surpass ten lozenges



dyclonine 

1 lozenge dissolve in mouth every 2 hours

maximum 10 lozenges can be used per day Not to exceed 10 lozenges/day



benzydamine 

Indicated for acute pharyngitis:


15 mL should be gargled or rinsed in the mouth for 30 seconds before being expelled every 1.5 to 3 hours



tyrothricin 

One lozenge orally
Note: do not chew or swallow the whole tablet
(or) Throat spray
Initial dose: spray orally 1-2times in about 2-3hours
Maintenance dose: spray orally once every six hours



 

cefadroxil

Children: 30 mg per kg orally per day or in divided doses twice a day
The maximum duration of the treatment in beta-hemolytic streptococcal infections is ten days



cefprozil

7.5

mg/kg

Tablet

Orally 

twice a day

10

days

Do not exceed 500 mg/dose



amoxicillin 

Children and Adolescents:  :


50 mg/kg/day orally daily or in divided doses 2 times a day for 10 days; may be increase up to 1,000 mg/day
  ER: 775 mg orally daily for 10 days 



penicillin v 

Age > 12 years:

125 - 250

mg

Orally 

every 6-8 hrs

10

days



penicillin G benzathine 

wt <27 kg: 600,000 U IM daily
wt > 27 kg: 1.2 million U IM daily



cefadroxil 

30

mg/kg

orally

daily



clindamycin 

Indicated for Streptococcal Pharyngitis:

20-30 mg/kg/day orally divided 3 times for Chronic carrier treatment
7 mg/kg/dose 3 times daily for 10 days for Acute treatment



cephalexin 

25 - 50

mg/kg

Capsule

Orally 

every 8 hrs

10

days



azithromycin 

Indicated for pharyngitis and tonsilitis in children
For <2 years: Safety and efficacy are not seen
≥2 years: 12 mg/kg orally each day for 5 days; do not exceed more than 500 mg/day



azithromycin 

<2 years: No evidence of safety or effectiveness
2 years and under: 12 mg/kg orally once day for 5 days; maximum daily dose of 500 mg.



benzocaine oropharyngeal 

2 years old or more: Spray onto the oral mucosa with an oral sprayer for approximately 0.5 seconds; repeat it for four times a day
5 years old or more: Allow the lozenge to melt gently in the mouth; repeat for every two hours as needed.

Teething
2 years old or more: Apply to gums or oral mucosa, leave on for one minute, then emit.
Apply up to four times a day, Do not exceed seven days.



dyclonine/menthol 

indicated for Pharyngitis & Cough
Age >2 years- allow the lozenge to dissolve gradually in the mouth
it can be taken every 2 hours as needed
The maximum daily intake should not exceed ten lozenges



dyclonine 

Age: > 2 years

1 lozenge dissolve in mouth every 2 hours

maximum 10 lozenges can be used per day Not to exceed 10 lozenges/day



benzydamine 

Children more than 6 years and adults: 15 mL should be gargled or rinsed in the mouth for 30 seconds before being expelled every 1.5 to 3 hours



tyrothricin 

For children aged 12 years and above:
One lozenge orally
Note: do not chew or swallow the whole tablet
(Or) Throat spray
For children aged seven years and above:
Initial dose: spray orally 1-2times in about 2-3hours
Maintenance dose: spray orally once every six hours



 

Media Gallary

References

https://www.ncbi.nlm.nih.gov/books/NBK519550/

Pharyngitis

Updated : February 15, 2024




Pharyngitis is an inflammation of the oropharynx’s mucosal surfaces. Most frequently, a viral or bacterial illness is to blame. Allergies, malignancy, trauma, reflux, and specific poisons are a few fewer common triggers of pharyngitis.

692,000 of the 1.814 million pharyngitis visits to emergency rooms in 2010 involved patients under the young of fifteen. Pharyngitis most frequently affects children younger than the age of five.

Although less frequently, the illness can also emerge in adults. Pharyngitis incidence is relatively high over the world, especially in nations whereby antibiotics are overmedicated.

The pharyngeal mucosal can be directly invaded by viruses and bacteria. Some viruses, such as the rhinovirus, can irritate the nose as a result of nasal discharges. There is nearly always a localized invasion of the pharyngeal mucous, which also causes an overabundance of edema and discharges.

Pharyngitis, or painful throat, symptoms are caused by a number of viral infections and are caused by 50 percent to 80 percent of cases. Mostly influenza, rhinovirus, adenovirus, parainfluenza, and coronavirus are the microorganisms that cause these illnesses. Herpes, the Epstein-Barr virus, the human immunodeficiency virus (HIV), and the coxsackievirus are less prevalent viral infections. After such a viral illness, more serious instances often turn out to be a bacterium.

Acute pharyngitis is most frequently brought on by Group A beta-hemolytic streptococcus, which accounts for 5 percent to 36percent of cases. Additional bacterial etiological factors include Candida, Arcanobacterium haemolyticum, Group B and C streptococcus, Mycoplasma pneumoniae, Chlamydia pneumoniae, Haemophilus influenzae, N. meningitides, N. gonorrhoeae, Corynebacterium diphtheriae, and Fusobacterium necrophorum.

Acute pharyngitis can also be brought on by chemical exposure and environmental allergens. Symptoms of other serious disorders, such as retropharyngeal abscess, peritonsillar abscess, Kawasaki disorder, and epiglottitis, may also include pharyngitis.

The outcome for pharyngitis is generally favorable because both bacterial and viral infections frequently self-limit to five to seven days. About 20 million people in underdeveloped nations contract acute rheumatic fever from group A streptococci infections.

The main factor in young people’s deaths is this disorder. Pharyngitis rarely results in death, but it can if the airway is damaged. The majority of pharyngitis cases heal in 7 to 10 days. Resistance to antibiotics, untreated close connections, and poor compliance are typically the causes of treatment failures.

cefprozil

500

mg

Tablet

Orally 

every 24 hours

10

days

If the infection is caused by S. pyrogenes, administer the dose for more than 10 days



amoxicillin 

500

mg

2 times a day or 1 g daily

10

days


ER: 775 mg daily for 10 days



penicillin v 

250

mg

orally

4 times a day

10

days



penicillin G benzathine 

1.2 million units given IM daily as a single dose



erythromycin ethylsuccinate 

400

mg

Orally 

divided in to 2 times a day

10

days



clarithromycin 

Indicated for Streptococcal pharyngitis:


250 mg oral tablet immediate release twice a day for 14 days



cephalexin 

250

mg

Capsule

Orally 

every 6 hrs



cefadroxil 

1

g

orally

daily

10

days


Note: indicated for pharyngitis and tonsillitis caused by Group A beta-hemolytic streptococci



azithromycin 

500 mg orally once a day, followed by 250 mg 4 times a day, on the 2nd to 5th day.



penicillin VK 

125 - 250

mg

Orally 

every 8 hrs

10

days



cefixime 

400 mg/day orally in single daily dose or divided every 12hr



azithromycin 

The drug treats inflammation in the pharynx and tonsils. Streptococcus pyogenes cause the infection; the dose for the same is 500 mg on the 1st day, followed by 250 mg drug four times daily on the 2nd to 5th day.



azithromycin 

Day 1: 500 mg orally in a single dosage;
Days 2–5: 250 mg orally per day



benzocaine oropharyngeal 

Spray onto the oral mucosa with an oral sprayer for approximately 0.5 seconds; repeat for four times daily.
Allow the lozenge to melt gently in the mouth; repeat for every two hours as needed.



dyclonine/menthol 

Indicated for Pharyngitis & Cough
Allow gradual dissolution of the lozenge in the oral cavity
can be repeated every two hours as needed
Ensure the total daily consumption does not surpass ten lozenges



dyclonine 

1 lozenge dissolve in mouth every 2 hours

maximum 10 lozenges can be used per day Not to exceed 10 lozenges/day



benzydamine 

Indicated for acute pharyngitis:


15 mL should be gargled or rinsed in the mouth for 30 seconds before being expelled every 1.5 to 3 hours



tyrothricin 

One lozenge orally
Note: do not chew or swallow the whole tablet
(or) Throat spray
Initial dose: spray orally 1-2times in about 2-3hours
Maintenance dose: spray orally once every six hours



cefadroxil

Children: 30 mg per kg orally per day or in divided doses twice a day
The maximum duration of the treatment in beta-hemolytic streptococcal infections is ten days



cefprozil

7.5

mg/kg

Tablet

Orally 

twice a day

10

days

Do not exceed 500 mg/dose



amoxicillin 

Children and Adolescents:  :


50 mg/kg/day orally daily or in divided doses 2 times a day for 10 days; may be increase up to 1,000 mg/day
  ER: 775 mg orally daily for 10 days 



penicillin v 

Age > 12 years:

125 - 250

mg

Orally 

every 6-8 hrs

10

days



penicillin G benzathine 

wt <27 kg: 600,000 U IM daily
wt > 27 kg: 1.2 million U IM daily



cefadroxil 

30

mg/kg

orally

daily



clindamycin 

Indicated for Streptococcal Pharyngitis:

20-30 mg/kg/day orally divided 3 times for Chronic carrier treatment
7 mg/kg/dose 3 times daily for 10 days for Acute treatment



cephalexin 

25 - 50

mg/kg

Capsule

Orally 

every 8 hrs

10

days



azithromycin 

Indicated for pharyngitis and tonsilitis in children
For <2 years: Safety and efficacy are not seen
≥2 years: 12 mg/kg orally each day for 5 days; do not exceed more than 500 mg/day



azithromycin 

<2 years: No evidence of safety or effectiveness
2 years and under: 12 mg/kg orally once day for 5 days; maximum daily dose of 500 mg.



benzocaine oropharyngeal 

2 years old or more: Spray onto the oral mucosa with an oral sprayer for approximately 0.5 seconds; repeat it for four times a day
5 years old or more: Allow the lozenge to melt gently in the mouth; repeat for every two hours as needed.

Teething
2 years old or more: Apply to gums or oral mucosa, leave on for one minute, then emit.
Apply up to four times a day, Do not exceed seven days.



dyclonine/menthol 

indicated for Pharyngitis & Cough
Age >2 years- allow the lozenge to dissolve gradually in the mouth
it can be taken every 2 hours as needed
The maximum daily intake should not exceed ten lozenges



dyclonine 

Age: > 2 years

1 lozenge dissolve in mouth every 2 hours

maximum 10 lozenges can be used per day Not to exceed 10 lozenges/day



benzydamine 

Children more than 6 years and adults: 15 mL should be gargled or rinsed in the mouth for 30 seconds before being expelled every 1.5 to 3 hours



tyrothricin 

For children aged 12 years and above:
One lozenge orally
Note: do not chew or swallow the whole tablet
(Or) Throat spray
For children aged seven years and above:
Initial dose: spray orally 1-2times in about 2-3hours
Maintenance dose: spray orally once every six hours



https://www.ncbi.nlm.nih.gov/books/NBK519550/

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