A patient presents with fever, sore throat, throat itching and children come with vomiting. In common term we call it sore throat.
Types of Pharyngitis
- Bacterial Pharyngitis
- Viral Pharyngitis
1.Bacterial Pharyngitis
Temperature is above 101F and it can be associated with rigors and chills,
2.Viral Pharyngitis
Temperature is below 101F and myalgia can be associated, cbc shows increased lymphocyte counts.
On examination
- Examine vitals.
- Examine oral cavity with tongue depressor to see red inflamed pharyngeal wall or enlarge tonsils (tonsillitis)
- Auscultate the chest.
- Palpate the abdomen to see lymphadenopathy.
Management
LABS
Ideally we take sample from throat swab for culture sensitivity.
CBC shows increased neutrophils counts for Bacterial Pharyngitis.
CBC shows increased Lymphocyte counts for Viral Pharyngitis.
Dosage for adult for Bacterial Pharyngitis
Dosage for adult whose age is above 12 years and weight is above 40kgs. Prescribe at least for 5 days. For Amoxicillin + Clavulanic Acid use PPI like cap omeprazole 40mg 1+0+0 before breakfast. Add salt in moderate water and gargle with it if patient has no cardic issues.
Don’t use cold, sour, and fried things.
| Category | Drug Name | Strength | Dosage Frequency | Pregnancy Safety | Child Safety | Male Fertility Safety |
| Antibiotics | Tab. Amoxicillin | 500 mg | TDS (1 + 1 + 1) | Safe | Safe | Safe |
| Tab. Amoxicillin + Clavulanic Acid | 625 mg | TDS (1 + 1 + 1) | Safe | Safe | No known impact | |
| Tab. Azithromycin | 500 mg | OD (1 + 0 + 0) | Safe | Safe | No known impact | |
| Tab. Clarithromycin | 500 mg | BD (1+0+1) | Not preferred | Use with caution | May reduce sperm motility temporarily | |
| Tab. Cefixime | 400 mg | OD (1 + 0 + 0) | Safe | Safe | No known impact | |
| NSAIDs (Pain/Inflammation Relief) | Tab. Ibuprofen | 400 mg | BD (1 + 0 + 0) | Avoid in 3rd trimester | Safe (above 6 months) | Long-term use may reduce sperm production |
| Tab. Paracetamol (Acetaminophen) | 500 mg | TDS (2 + 2 + 2) | Safest | safe | High doses may affect testosterone levels | |
| Antihistamines | Tab. Fexofenadine | 60 mg | HS (1 + 0 + 1) | Safe (above 6 months) | No known impact | |
| Tab. Cetirizine Dihydrochloride | 10 mg | HS (0 + 0 + 1) | Safe | Safe (above 6 months) | No known impact | |
| Tab Loratadine | 10 mg | HS (0 + 0 + 1) | Safe | Safe (above 2 years) | No known impact |
Dosage for adult for Viral Pharyngitis
In viral Pharyngitis patient presents with mild fever, body aches, loss of hunger. We will give symptomatic treatment means which system is effect we will treat it.
Give Tab Paracetamol tds(2+2+2). Viral rhinitis and Viral bronchitis can be seen with Viral Pharyngitis
Dosage for Peads
Dosage for pediatrics whose age is below 12 years and weight is below 40kgs. If age is above 12 and weight is below 40kgs still receive pediatrics dosage
1 Tea spoon = 5ml
1 tea spoon for less than 1year baby
1.5 tea spoon for 2-5 year old baby
2 tea spoon for above 5 year old baby
| Category | Drug Name | Strength (per 5mL) | Dosage Frequency | Pediatric Dosage (Weight-Based) | Age Restriction |
| Antibiotics | Syrup Amoxicillin | 250 mg/5mL | TDS(1+1+1) | 15-30mg/kg/day in divided doses | Safe for all ages |
| Syrup Amoxicillin + Clavulanic Acid | 228 mg/5mL | TDS(1+1+1) | 15-30 mg/kg/day in divided doses | Safe for all ages | |
| Syrup Azithromycin | 200 mg/5mL | OD(1+0+0) | 10 mg/kg on Day 1, then 5 mg/kg | Safe (above 6 months) | |
| Syrup Cefixime | 100 mg/5mL | BD(1+1+0) | 8 mg/kg/day in divided doses | Safe (above 6 months) | |
| NSAIDs | Syrup Paracetamol | 120 mg/5mL | TDS(1+1+1) | 10-15 mg/kg/dose | Safe for all ages |
| Syrup Ibuprofen | 100 mg/5mL | TDS(1+1+1) | 5-10 mg/kg/dose | Safe (above 6 months) | |
| Antihistamines | Syrup Cetirizine | 5 mg/5mL | OD(1+0+0) | 2.5 mg (6m-2y), 5 mg (2-6y), 10 mg (6y+) | Safe (above 6 months) |
| Syrup Loratadine | 5 mg/5mL | OD(1+0+0) | 2.5 mg (2-5y), 5 mg (6y+) | Safe (above 2 years) |
Syp. Dimenhydrinate TDS 1.5 TSF in case of vomiting.
How to determine dosage per kg for peads
To calculate the Paracetamol dose for a 4-year-old boy using 120 mg/5 mL syrup:
Step 1: Determine the dose per kg
Paracetamol dose = 10–15 mg/kg per dose
Example: If the child weighs 16 kg (approximate weight for a 4-year-old), then:
- Minimum dose: 10 mg × 16 kg = 160 mg
- Maximum dose: 15 mg × 16 kg = 240 mg
Step 2: Convert mg to mL
Since the syrup contains 120 mg per 5 mL:
- Minimum dose: (160 mg ÷ 120 mg) × 5 mL = 6.7 mL (~6.5 mL)
- Maximum dose: (240 mg ÷ 120 mg) × 5 mL = 10 mL
Final Dosage Recommendation
A 4-year-old (16 kg) can take 6.5 – 10 mL per dose, every 4-6 hours (max 4 doses/day).
Always confirm the child’s weight for an accurate dose!