Environmental and non-infectious factors in the aetiology of pharyngitis (sore throat)

Abstract

ObjectivesThe aim of this review is to examine the causes, pathophysiology and experimental models of noninfectious pharyngitis (sore throat). Introduction The causes of sore throat can be infectious (viruses, bacteria, and fungi) or non-infectious, although the relative proportion of each is not well documented. Methods A PubMed database search was performed for studies of non-infectious sore throat. Results and conclusions Non-infectious causes of sore throat include: physico-chemical factors, such as smoking, snoring, shouting, tracheal intubation, medications, or concomitant illness; and environmental factors including indoor and outdoor air pollutants, temperature and humidity, and hazardous or occupational irritants. The pathophysiology underlying non-infectious sore throat is largely uncharacterised, although neurogenic inflammation looks to be a promising candidate. It is likely that there will be individual disposition factors or the coincidence of more than one irritant with possible-up to now unknown-interactions between them. Therefore, experimental models with defined conditions and objective endpoints are needed. A new model using cold dry air to directly induce pharyngeal irritation in humans, with pharyngeal lavage to measure biomarkers, may provide a useful tool for the study of mechanisms and treatment of non-infectious sore throat.

Efficacy of flurbiprofen 8.75 mg spray in patients with sore throat due to an upper respiratory tract infection: A randomised controlled trial

“…[1][2][3] Inflammatory mediators are thought to be responsible for sore throat, as demonstrated in studies where nasal or oropharyngeal challenge with bradykinin and prostaglandins caused sore throat symptoms, [3][4][5][6] and stimulation of the pharyngeal mucosa with cold dry air increased inflammatory mediators and caused pain. [7] Most adult cases ($85-95%) are caused by viral upper respiratory tract infection (URTI), [1,2] although other causes include bacterial infections (including group A bhaemolytic streptococcus [GABHS], $10% of cases) and non-infectious factors including smoking and air pollution.…”

“…[7] Most adult cases ($85-95%) are caused by viral upper respiratory tract infection (URTI), [1,2] although other causes include bacterial infections (including group A bhaemolytic streptococcus [GABHS], $10% of cases) and non-infectious factors including smoking and air pollution. [2,3] URTI is a common reason for primary care consultations and as viruses cause most sore throats, antibiotics are not usually appropriate. [1,8] However, physicians continue to prescribe antibiotics inappropriately for sore throat and these prescribing practices contribute to the growing global problem of antibiotic resistance.…”

“…[13] Flurbiprofen, a non-steroidal anti-inflammatory drug (NSAID), targets inflammation, a key cause of sore throat symptoms. [3,21] Previous studies have demonstrated the efficacy of flurbiprofen lozenge and granule formulations (8.75 mg per dose) for symptomatic relief of sore throat. [22][23][24] Recently, an innovative spray formulation containing 8.75 mg of flurbiprofen per dose has been developed for sore throat symptom relief.…”

A study on the drug prescribing pattern in acute, recurrent and chronic pharyngitis at a tertiary care hospital

“…Other studies have also reported a higher prevalence of acute pharyngitis compared to chronic or recurrent. 10,11 None of the subjects had history of allergic reactions to the commonly used AMAs like beta-lactams, flouroquinolones or macrolides. Recording and scrutinizing the data about the previous medications may help to analyse the pattern of exposure to AMAs, to elicit any history of allergy or intolerance and also to consider any possibility of resistance to the previous AMA therapy.…”

A randomized, double-blind, controlled study to evaluate clinical efficacy and safety of novel filmogen osmotic treatment for pharyngitis

“…Sore throat or pharyngitis is very common, largely seasonal conditions that are primarily caused by a viral infection of the upper respiratory tract (URT) [1][2][3]. While rhinoviruses, responsible for the common cough and cold, do not afflict significant damage to the respiratory mucosa, Influenza A infection can be much more serious [4].…”