7.2 Laryngitis / Laryngopharyngitis / URTI
| Type of Infection | First Line (with Dosage and Duration) |
Alternative First Line (with dosage and Duration) |
Comments |
|---|---|---|---|
| Uncomplicated Viral infection | No antibiotics needed, only symptomatic management | 90% are viral infections, so no antibiotics needed. Symptomatic therapy- Steam inhalation, voice rest and warm saline gargles. |
For common etiological agents of Laryngitis / Laryngopharyngitis / URTI, see Annexure B.7.2
Additional Information
- Laryngitis usually gets better on its own within 1 to 2 weeks.
- Empiric therapy of Oseltamivir, in patients with influenza like illness during an ongoing outbreak, if they are at high risk of complications such as pregnant women, those with co- morbidities and the immunocompromised.
- For antimicrobial therapy in URTI, see the information below: Antimicrobial therapy in URTI:
Condition
Preferreddrug
Alternative
Penicillin allergy
Acute pharyngitis with low Centor score (≤2)
No antibiotics required
Acute Pharyngitis with high Centor score (≥3)
Amoxicillin 1g TDS for 5-7 days
Amoxicillin- clavulanate 1g BD for 5-7 days
Anaphylactic: clindamycin/ clarithromycin/ azithromycin Non- anaphylactic: cephalexin/cefadroxil
Membranous pharyngitis
Erythromycin 500 mg IV QID Or Azithromycin 500mg OD Or Penicillin G 50000 units/kg IV 12 hrly Diphtheria antitoxin: Horse serum < 48 hours: 20,000-40,000 units, Nasopharyngeal membranes: 40,000- 60,000 units
>3 days and bull neck: 80,000-1,20,000 units
- CentorScore(Modified/McIsaac):is used to estimate the probability of Group A Streptococcus (GAS) pharyngitis and suggest further management course.
Clinicalvariable
Score
Age:
3-14 years
14-44 years
>44 years
1
0
-1
High fever (>100.4 F)
1 Tonsillar Exudate
1 Absence of cough
1 Presence of Lymphadenopathy
1
Interpretation of Centor Score:
-
Low risk (0-1): A low Centor score suggests a low probability of strep throat, and further testing or antibiotic treatment may not be necessary.
-
Moderate risk (2): A score of 2 indicates a moderate risk. Some guidelines suggest rapid strep testing.
-
High risk (3-4): A higher Centor score (3 or 4) indicates a higher probability of strep throat, and further testing (rapid antigen test or throat culture) is generally recommended, along with consideration for antibiotic treatment if the test is positive.