Adult Sore Throat Treatment (Acute Pharyngitis)
MD-only online sore throat evaluation for adults in California with guideline-based screening for viral vs bacterial causes, safe symptom relief, and clear red-flag triage. $49 flat-fee video visit, no insurance required.
Most adult sore throats are viral and do not need antibiotics. When strep throat is likely, TeleDirectMD focuses on appropriate testing and antibiotic stewardship, plus safety screening for urgent conditions.
- Evaluation for strep throat risk and complications
- Supportive care plan for pain, hydration, and recovery
- Return-to-work guidance and optional brief work note when appropriate
- Adults only (18+), video visit only
What Is a Sore Throat?
A sore throat is throat pain or irritation, often worse with swallowing. In adults, the most common cause is viral pharyngitis from routine respiratory viruses. Bacterial causes like group A strep are less common in adults but important to identify because appropriate antibiotics can reduce complications and shorten contagiousness.
TeleDirectMD evaluates symptom pattern, exposures, timing, and risk factors. The goal is to distinguish viral vs bacterial causes, recommend testing when needed, treat symptoms safely, and identify red flags that should be evaluated in person.
Symptoms and Red Flags
| Symptom | What it suggests | Telehealth appropriate? | Red flag requiring urgent in-person care |
|---|---|---|---|
| Sore throat with cough, runny nose, hoarseness | Viral pharyngitis more likely | Often yes | Breathing difficulty or inability to swallow fluids |
| Fever with tender front neck nodes and no cough | Higher strep likelihood, testing often appropriate | Often yes if stable | Neck swelling, severe headache, stiff neck |
| White exudate on tonsils | Can be strep or viral (including mono) | Often yes | Severe one-sided throat pain with drooling or muffled voice |
| Severe one-sided throat pain, trismus, muffled voice | Possible peritonsillar abscess | Often no | Urgent evaluation for drainage and airway assessment |
| Prolonged fatigue with sore throat | Possible infectious mononucleosis | Sometimes | Severe abdominal pain or fainting, concern for splenic issues |
| Rash with sore throat | Could be viral or strep-related rash | Often yes | Rapidly spreading rash, facial swelling, or trouble breathing |
What Else Can Cause Sore Throat?
Viral upper respiratory infection
Most common cause. Often includes cough, congestion, hoarseness, or eye irritation.
Strep throat (group A strep)
More likely with fever, tender front neck nodes, and no cough. Testing helps confirm before antibiotics.
Infectious mononucleosis
Can cause sore throat, fatigue, swollen nodes, and tonsillar exudate. Testing may be needed.
Reflux or postnasal drip
Often worse in the morning, may occur with heartburn or chronic throat clearing.
Peritonsillar abscess
Severe one-sided pain, muffled voice, drooling, or difficulty opening the mouth needs in-person care.
Less common infections
Gonococcal pharyngitis or other causes may be considered based on exposure history and symptoms.
Telehealth Eligibility
TeleDirectMD is appropriate for many adults with sore throat when symptoms are stable. Your physician screens for urgent conditions and helps decide when strep testing or in-person evaluation is safest.
When a Video Visit Is Appropriate
- Adult 18+ with sore throat and mild to moderate symptoms.
- Able to swallow fluids and stay hydrated.
- No breathing difficulty, drooling, or severe one-sided throat pain.
- No concerning neck swelling or stiff neck.
- Physically located in California at the time of the visit.
Red Flags Requiring In-Person or ER Care
- Trouble breathing, drooling, or inability to swallow fluids.
- Muffled voice, severe one-sided throat pain, or trismus.
- Neck swelling, stiff neck, severe headache, or confusion.
- Severe dehydration, fainting, or chest pain.
- Rapidly worsening symptoms or severe immunocompromise.
Treatment Options
Supportive care
- Warm fluids, honey, and throat lozenges as tolerated.
- Salt-water gargles and humidified air.
- Hydration and rest.
Pain and fever control
- Acetaminophen or ibuprofen when safe for you.
- Avoid duplicate acetaminophen products.
- NSAIDs may not be appropriate with kidney disease, ulcers, or blood thinners.
Strep testing and antibiotics
- Antibiotics do not help viral sore throat.
- When strep is likely, TeleDirectMD may recommend rapid strep testing or treat based on clinical criteria when appropriate.
- Antibiotic selection is based on allergy history and safety screening.
TeleDirectMD does not prescribe controlled substances for sore throat visits.
Medication Table
Common adult regimens are listed below. Your TeleDirectMD physician individualizes treatment based on your symptoms, history, allergies, and risk factors.
| Medication | Dose | Duration | When used |
|---|---|---|---|
| Acetaminophen | 650 mg by mouth every 6 hours as needed | As needed | Throat pain, fever, or body aches when safe for the patient. |
| Ibuprofen | 400 mg by mouth every 6 to 8 hours as needed with food | As needed | Throat pain or fever when safe for the patient. |
| Penicillin V | 500 mg by mouth 2 times daily | 10 days | Confirmed or highly suspected strep throat when no penicillin allergy. |
| Amoxicillin | 500 mg by mouth 2 times daily | 10 days | Confirmed or highly suspected strep throat when no penicillin allergy. |
| Cephalexin | 500 mg by mouth 2 times daily | 10 days | Strep throat in select patients with non-anaphylactic penicillin allergy. |
| Azithromycin | 500 mg by mouth once on day 1, then 250 mg by mouth once daily on days 2 to 5 | 5 days | Strep throat in select patients with penicillin allergy when clinically appropriate. |
| Dexamethasone | 10 mg by mouth once | Single dose | Selected adults with severe throat pain after safety screening and contraindication review. |
Home Care and Return to Work
Home care checklist
- Drink fluids regularly and prioritize sleep.
- Use acetaminophen or ibuprofen when safe for you.
- Gargle salt water and use humidified air if helpful.
- Avoid smoking and alcohol while symptoms are active.
Return to work
- If viral, many adults return when fever-free and able to function safely.
- If strep and antibiotics are started, contagiousness typically drops after 24 hours.
- Workplace policies vary. TeleDirectMD can provide a brief work note when medically appropriate.
If symptoms worsen, new breathing symptoms develop, or you cannot maintain hydration, seek urgent in-person evaluation.
TeleDirectMD sore throat visits
TeleDirectMD provides MD-only virtual urgent care for adults for $49 flat-fee video visits in 25+ states. Your physician reviews symptoms, timing, risk factors, and prior testing. We provide guideline-based evaluation, symptom relief guidance, and antibiotic stewardship when bacterial infection is likely, plus clear thresholds for urgent in-person care. No controlled substances are prescribed.