Useful Tips

Bacterial pharyngitis: features of the course and principles of therapy


The co-author of this article is Chris M. Matsko, MD. Dr. Matsko is a former doctor from Pennsylvania. He graduated from Temple University Medical School in 2007.

The number of sources used in this article is 15. You will find a list of them at the bottom of the page.

Bacterial pharyngitis is a sore throat caused by bacteria. Usually, bacterial pharyngitis occurs due to group A streptococcus, although chlamydia and gonorrhea can also cause this disease. When the causes of pharyngitis are established, use a combination of medication and folk remedies to cure the disease and recover from the infection.

Attention:The information in this article is for informational purposes only. Before using prescriptions, consult your doctor.

Clinical picture

The incubation period of bacterial pharyngitis averages 3-4 days. The first signs of the disease develop gradually, within 24-48 hours.

Acute inflammation of the pharynx is characterized by a complex of symptoms:

  • soreness, tickle, tickling in the throat,
  • unpleasant pain when swallowing, giving to the jaw and auricles,
  • joining a runny nose with mucous or mucopurulent discharge (see When and why mucus appears in the throat),
  • an increase in body temperature to 37.5-38.0 degrees (in children, this figure can reach 39-40 ° C),
  • dry paroxysmal cough caused by swelling of the oropharynx and irritation of the receptors,
  • enlargement, soreness of the submandibular and cervical lymph nodes.

Bacterial pharyngitis in children is difficult, with severe symptoms of intoxication (weakness, fatigue, headache). The child is lethargic, moody, refuses food and often cries.


In the absence of proper treatment, bacterial pharyngitis can cause the following complications:

  1. Paratonsillar abscess. The pus that accumulates in the oropharynx is covered with a connective tissue capsule and remains in the body for a long time. Such a formation causes sharp pain when swallowing and practically deprives a person of the ability to eat.
  2. Generalized infection. If pharyngitis is caused by streptococcus or staphylococcus, its pathogens can spread throughout the body with a blood stream, causing bacteremia (blood poisoning) and a skin rash. The development of glomerulonephritis and acute rheumatic fever are also dangerous consequences of the generalization of the inflammatory process.
  3. Chronization of the process. Untreated acute pharyngitis risks becoming chronic. In this case, the disease takes on a sluggish form with a wave-like course (exacerbations that occur against the background of relative well-being).

Bacterial pharyngitis: etiology

Bacterial pharyngitis is an inflammation of the pharynx that develops as a result of the ingress of pathogenic microorganisms into it. Bacteria can enter the body from the outside. However, sometimes the cause of pharyngitis is the presence of inflammatory foci in adjacent tissues.

Most often, exacerbations of this disease are observed during the off-season, when the human immune system is significantly weakened.


A doctor can already suggest a diagnosis of bacterial inflammation of the pharynx during pharyngoscopy. The throat with pharyngitis is hyperemic, edematous, the palate and the posterior pharyngeal wall acquire a special granularity. Purulent plugs and even crusts on the mucosa are possible.

With absolute certainty, the following methods allow determining the pathogen of infection:

  • bacteriological examination of a swab from the oropharynx: sowing biomaterial on a nutrient medium and growing colonies of microorganisms with a determination of sensitivity to antibiotics,
  • Microscopy of the obtained samples with Gram staining,
  • PCR diagnostics - determination of the DNA of bacteria circulating in the blood.

Also, to assess the patient's condition, it may be necessary to pass general clinical blood and urine tests.

The reasons provoking factors

Acute pharyngitis of a bacterial nature can be an independent pathology or a consequence of the ingestion of harmful microorganisms. Most often, the anomaly develops as a result of infection with these types of bacteria:

The risk of the onset of the disease increases in such cases:

  • frequent colds
  • weakening of immunity,
  • bad habits,
  • violation of personal hygiene rules,
  • promiscuous sex
  • inhalation of polluted air
  • harmful working conditions
  • chronicity of the acute process.

What is the difference between viral pharyngitis and bacterial pharyngitis:

The bacterial form of pharyngitis rarely has an isolated course. As a rule, inflammation of the entire nasopharynx, including the larynx, is observed. An isolated course of the disease usually occurs with a burn of the mucous membranes, a relapse of a chronic disease, or the use of cold foods.

In adults

Pathology is accompanied by such manifestations:

It can be difficult to identify signs of bacterial pharyngitis in a child. Most often, the baby is naughty, crying, losing his appetite. In infants, the manifestations of the disease resemble the signs of any colds. An isolated form of pathology already in 2-3 days passes into nasopharyngitis. This is due to the anatomical proximity of the ENT organs.

General Provisions

Bacterial pharyngitis remains a pathology requiring attention not only from the doctor, but also from the patient: the treatment of the disease should be comprehensive and include not only antibiotics (see Antibiotics for pharyngitis: which to take), but also compliance with the general recommendations of specialists:

  1. Maintaining optimal living conditions in the patient’s room (comfortable temperature, humidity at the level of 50-60%, frequent airing and wet cleaning, performed daily).
  2. Quitting smoking and alcohol (at least during treatment). Toxic substances contained in tobacco smoke and spirits, not only irritate the inflamed mucosa, but are also incompatible with antibiotics.
  3. A sparing diet with the restriction of very cold or very hot dishes, avoiding coarse, spicy, spicy or sour foods (crackers, chips, nuts, pickled vegetables, Korean salads, dishes cooked with a lot of seasonings and spices). Try to eat food with a liquid or semi-liquid consistency (cereals, mashed potatoes, light soups).
  4. Rest and healthy sleep. It is imperative to relax and allow yourself to lie in bed without thinking about anything.

Antibiotic prescription

Antibiotics are the main drugs for treating bacterial pharyngitis. The main representatives of this pharmacological group are presented in the table below.

Table: Antibiotics for the treatment of pharyngitis:

PenicillinsFirst-generation drugs lose their effectiveness every year due to the lack of a substance in their composition that blocks the bacterial enzyme beta-lactamase.

Modern protected penicillins have a higher activity.

Most drugs of the group have good bioavailability (they are absorbed into the blood through the digestive tract by 93-98%), so they can be taken in the form of tablets or suspensions (infant form).

Amoxicillin (Amosin, Flemoxin Solutab, Ospamox)
Amoxiclav / Clavulonic acid (Augmentin, Amoxiclav)
Amoxiclav / Sulbactam (Unazin)
CephalosporinsLike penicillins, they have a bactericidal effect (they irreversibly destroy bacteria by destroying their cell wall).

They have cross sensitivity with penicillins: they are also forbidden to use with intolerance to the latter.

Precautions are prescribed for chronic diseases of the liver and kidneys.

Ceftriaxone (Toroceph, Longicef)
Cefazolin (cefozol)
Cefixim (Suprax, Pantsef)
Cefuroxime (Zinnat, Proxim)

With severe inflammation, it is also possible to prescribe antibiotics from the group of macrolides, fluoroquinolones.

Note! The selection of an antibiotic for the treatment of pharyngitis should be done by a doctor. Carefully follow the recommendations of a specialist and familiarize yourself with the materials contained in the instructions before use.


To cope with pain, tickle and other unpleasant sensations in the throat can symptomatic means - sprays, gargles, lozenges and lozenges.

They have antiseptic, anti-inflammatory properties and soften the throat well:

  1. Aerosols for irrigation of the throat: Yoks, Ingalipt, Tantum Verde, Stopangin.
  2. Rinses: Chlororexidine, Miramistin, Hexoral, Chlorophyllipt.
  3. Tablets, lozenges for resorption: Faringosept, Lizobakt, Strepsils, Septolete.

Alternative methods of treatment

Traditional medicine has many recipes for proven remedies for sore throat. Unfortunately, most of them do not affect the cause of the disease - pathogenic microbes, and do not exclude the need for antibiotics. But they significantly facilitate the course of infection and quickly defeat discomfort.

Common methods for treating pharyngitis include:

  1. Gargling with saline: you can buy it in a pharmacy or cook it yourself by dissolving 1 teaspoon in a glass of warm water. salt.
  2. Gargling with decoctions of herbs with anti-inflammatory effect (chamomile, sage, string, eucalyptus).
  3. Reception of dried clove buds: to reduce sore throat, it is recommended to chew 1-2 pieces every 4 hours.
  4. Honey-garlic compresses on the throat.

Preventive measures

Of course, any disease is easier to prevent than to cure. To avoid infection, lead a healthy lifestyle, eat well, engage in active sports and hardening.

After visiting public transport and other rooms where a large number of people are in a limited space, rinse your mouth with warm boiled water to prevent infection.

With a serious approach to treatment, bacterial pharyngitis in children and adults does not pose a health hazard. Properly selected antibiotics significantly improve the condition already on the 2nd-3rd day of administration.

What is different from viral

In general, these types of pharyngitis are similar. The main difference between the bacterial form of the disease is an acute onset, which manifests itself in the form of a significant increase in temperature. This indicator can increase to 39-40 degrees. With the viral nature of the disease, the temperature usually does not exceed 38 degrees.

What is the difference between viral pharyngitis and bacterial pharyngitis

In order for therapy to be as effective as possible, it is very important to consult a doctor in a timely manner. The specialist will select the appropriate treatment, taking into account the clinical picture of the disease.

General recommendations

To achieve good results and avoid complications of a bacterial infection, you should adhere to such recommendations:

  1. Remove spicy foods from the menu. Cold and hot foods are also prohibited.
  2. Refuse from increased physical exertion.
  3. Reorganize infected foci in the upper respiratory tract. To do this, it is recommended to remove tonsils, polyps, adenoids. It may also be necessary to treat carious teeth.
  4. Stop smoking and drinking alcohol.
  5. Conduct hardening of the body.
  6. Systematically carry out wet cleaning indoors, ventilate the room.
  7. Avoid contact with infected people.


Treatment of pathology depends on the type of pathogen. However, in any case, the patient should take antibiotics. If pharyngitis is of gonococcal origin, treatment is carried out under the supervision of a venereologist. In this case, it is imperative to abandon the intimate life and strictly observe the rules of hygiene.

The staphylococcal form of pharyngitis requires the use of antibiotics from the macrolide category. In difficult situations, cephalosporins can be used. If the cause of the disease is infection with streptococci, combined penicillins are used. Gonorrheal pharyngitis is eliminated with the help of fluoroquinolones. Sometimes they are combined with other antibiotics.

Almost always, the patient is prescribed local antibacterial drugs. In this case, Grammidin resorption tablets and Bioparox throat spray can be used.

Sore Throat Medication

Folk remedies

In addition to traditional remedies, effective homemade recipes can be used:

  1. Mix 1 tablespoon of eucalyptus and pine cones, add 500 ml of water and leave to insist for inhalation. Then warm the composition to a boil and inhale the vapor using a steam inhaler or funnel.
  2. Drink milk with honey. To prepare the treatment mixture, you need to mix a glass of milk with 1 tablespoon of honey. It is equally useful to use royal jelly and pollen.
  3. Add a small spoonful of sea salt to 1 cup of water, as well as 2 drops of thyme or eucalyptus essential oil. Use a finished rinse.
  4. Take 1 tablespoon of honey and chopped horseradish, add 250 ml of water and drink in small sips throughout the day.

Features of treatment during pregnancy

During this period, it is strictly forbidden to engage in self-medication. The doctor may recommend rinsing with herbal decoctions and solutions of medicines. The most effective substances include Rotokan, Chlorhexidine.

Local anti-inflammatory drugs help improve the condition. These include Strepsils, Lizobakt. However, drugs such as Falimint and Septolete are strictly prohibited during pregnancy.

With bacterial pharyngitis, the doctor will prescribe the approved antibacterial drug. With an easy course of the disease, local antibiotics are used - for example, Bioparox.

Possible complications

If you do not immediately pay attention to the symptoms, pathology can cause dangerous consequences. In the absence of drug therapy, pathogenic bacteria multiply at high speed. This leads to the suppression of the protective functions of the body.

If the pathology is not treated, it will become chronic. As a result, there is a risk of spreading the infection to other respiratory organs. This can lead to such complications:

Other possible complications of bacterial pharyngitis that are commonly found in children include the following:


It is very difficult to protect against the effects of pathogenic bacteria. However, minimizing the risk of developing the disease will help strengthen immunity.

Vitamins, minerals, immunomodulators have beneficial effects on health. Taking such funds is especially important during the period of seasonal exacerbations of the disease, which are often observed in autumn and spring. Quitting smoking is important to prevent pharyngitis.

Prevention of pharyngitis and other inflammatory diseases of the throat:

With adequate and timely therapy, the acute form of bacterial pharyngitis is well treatable. If the process has become chronic, it will not be possible to completely get rid of it. However, the use of drugs and physiotherapeutic agents will help achieve sustainable remission.

Bacterial pharyngitis is a common pathology that leads to serious health consequences. To avoid complications, you should contact the otolaryngologist in time and carefully follow his recommendations.