Adult Sore Throat Treatment (Acute Pharyngitis)
Pain with swallowing, throat irritation, and swollen glands are common in acute pharyngitis. TeleDirectMD connects you with a board-certified MD for guideline-based evaluation and, when appropriate, targeted treatment for strep throat by secure video visit, while avoiding unnecessary antibiotics for viral infections.
- $49 flat-fee visit, no surprise bills
- MD-only care, no mid-level substitutions
- No insurance required, HSA/FSA-friendly
- Available in 25+ states by secure video visit
TeleDirectMD is physician-led virtual urgent care. Every visit is with a real doctor, Parth Bhavsar, MD.
What Is Acute Pharyngitis (Sore Throat) in Adults?
Acute pharyngitis is inflammation of the throat, most often caused by respiratory viruses and less commonly by group A streptococcal bacteria (strep throat) or other pathogens. Symptoms can include throat pain, painful swallowing, swollen glands, low-grade fever, and fatigue. Viral pharyngitis is far more common than strep throat in adults.
Because most sore throats are viral, antibiotics usually provide no benefit and may cause side effects or contribute to antibiotic resistance. The key is to distinguish likely viral pharyngitis from situations where strep throat or other causes should be considered and tested.
During your TeleDirectMD visit, an MD reviews your symptoms, timing, risk factors, Centor-style criteria, and associated signs to determine if your sore throat is likely viral or if in-person testing for strep or other conditions is recommended.
Symptoms and Red Flags for Adult Sore Throat
This table highlights typical sore throat features versus findings that should trigger in-person or emergency care.
| Symptom | What It Suggests | Telehealth Appropriate? | Red Flag Requiring In-Person or ER Care |
|---|---|---|---|
| Sore throat with cough, congestion, or runny nose | More consistent with viral pharyngitis or common cold than strep throat | Yes, telehealth is appropriate for evaluation and home care guidance | In-person care if symptoms worsen with high fever, shortness of breath, or chest pain |
| Sore throat with sudden onset fever and tender neck nodes | Could represent group A strep, especially without cough or congestion | Telehealth can assess risk and direct you to local strep testing when indicated | Urgent evaluation if associated with drooling, muffled voice, or severe systemic illness |
| Painful swallowing but able to drink fluids | Typical of mild to moderate pharyngitis | Yes, telehealth can guide symptomatic care and when to test | In-person care if unable to swallow liquids or medications at all |
| White patches or exudate on the tonsils | Can occur with strep, viral infections, or mononucleosis | Telehealth can triage, but testing may require in-person evaluation | ER care if paired with severe pain, drooling, or difficulty opening the mouth |
| Hoarseness and sore throat after heavy voice use | Suggests viral laryngitis or voice strain more than strep | Yes, telehealth is appropriate for counseling and symptom relief | In-person evaluation if hoarseness persists beyond a few weeks or has red-flag features |
| Unilateral severe throat pain with ear pain | May indicate peritonsillar abscess or more serious local infection | No, this goes beyond uncomplicated telehealth pharyngitis care | Requires urgent in-person or emergency evaluation |
| Drooling, difficulty handling secretions, or muffled “hot potato” voice | Concerning for airway-threatening infections such as epiglottitis or abscess | No, not appropriate for telehealth alone | Emergency evaluation is needed immediately |
| Shortness of breath, chest pain, or stridor | Suggests lower airway involvement or serious complication | No, beyond uncomplicated sore throat management | Emergency care is required |
| Rash with sore throat and fever | Could represent scarlet fever, viral exanthem, or drug reaction | Telehealth can triage, but in-person exam and testing are often recommended | ER care if accompanied by blistering, skin peeling, or systemic illness |
| Prolonged sore throat with fatigue and swollen glands | May indicate mononucleosis or another systemic infection | Telehealth can guide workup and timing of in-person testing | In-person evaluation if significant abdominal pain, marked lymph node enlargement, or jaundice develops |
How We Distinguish Viral Sore Throat from Strep and Other Causes
Many conditions cause throat pain. During your TeleDirectMD video visit, your physician uses structured history, risk scoring, and visual inspection (when possible over video) to narrow down the most likely diagnosis and decide when in-person testing is needed.
- Viral pharyngitis: Sore throat with cough, congestion, runny nose, hoarseness, or conjunctivitis, often with low-grade fever and milder systemic symptoms. Antibiotics do not help.
- Group A strep throat: Sudden sore throat with fever, tender neck nodes, and tonsillar exudates, usually without cough or congestion. Diagnosis typically requires in-person rapid testing or throat culture.
- Infectious mononucleosis: Prolonged sore throat, fatigue, swollen glands, and sometimes enlarged spleen. May need in-person evaluation and lab testing.
- Peritonsillar abscess: Severe unilateral throat pain, difficulty opening the mouth, drooling, or muffled voice. Requires urgent in-person evaluation and is not appropriate for telehealth alone.
- Laryngitis or voice strain: Hoarseness and throat discomfort after heavy voice use or viral illness. Often managed with voice rest and supportive care.
- Gastroesophageal reflux–related throat symptoms: Chronic throat clearing, heartburn, or sour taste; often more of a chronic pattern than acute infection.
The goal is to identify adults who likely have viral sore throat that can be managed at home, those who need in-person strep testing before antibiotics, and those with red flags requiring urgent face-to-face care.
When a Video Visit Is Appropriate for Sore Throat
When a TeleDirectMD Video Visit Is Appropriate
- Adult, speaking in full sentences, no obvious breathing distress
- Sore throat with or without low-grade fever, congestion, or cough
- Able to swallow liquids and medications, even if uncomfortable
- No drooling, muffled voice, or difficulty handling secretions
- Seeking guidance on strep risk, testing needs, and symptom relief
- Comfortable going for local strep testing if recommended
Red Flags Requiring In-Person or ER Care
- Drooling, inability to swallow, or trouble handling saliva
- Muffled “hot potato” voice or severe difficulty opening the mouth
- Shortness of breath, stridor, or chest pain
- Severe unilateral throat pain with facial or neck swelling
- Confusion, lethargy, or signs of systemic toxicity
- Very high or persistent fever with rapidly worsening symptoms
If any red flag is present, do not rely on virtual care alone. Seek urgent in-person or emergency evaluation promptly, and call emergency services if there is concern for airway compromise or life-threatening illness.
How TeleDirectMD Treats Adult Sore Throat
TeleDirectMD emphasizes careful differentiation between viral and bacterial causes, evidence-based use of antibiotics only when indicated, and clear guidance on when in-person strep testing or emergency care is needed.
Supportive and Symptom-Based Care
- Use of acetaminophen or ibuprofen when appropriate for throat pain and fever
- Warm saltwater gargles, throat lozenges, and adequate hydration
- Humidified air and avoidance of smoking or secondhand smoke
- Short-term use of topical anesthetic lozenges or sprays when appropriate
- Cough suppression strategies when an associated cough is present and safe to treat
When Antibiotics Are Considered
Antibiotics are reserved for adults with a high likelihood of group A strep based on clinical criteria and appropriate testing. TeleDirectMD physicians use guideline-based risk assessment and may direct you to a local clinic, lab, or urgent care for rapid strep testing before prescribing.
Antibiotic Stewardship
- Antibiotics are not prescribed for clearly viral sore throats
- When strep is confirmed, narrow-spectrum agents and appropriate durations are used
- We avoid unnecessarily broad-spectrum antibiotics for routine pharyngitis
- We provide clear instructions on expected improvement and when to escalate care
Common Medications for Adult Sore Throat
Medication choices depend on your medical history, other medications, and whether strep throat has been confirmed or strongly suspected. The table below shows commonly used options for adults. Exact dosing and suitability are always individualized.
| Medication | Dose | Duration | When It Is Used |
|---|---|---|---|
| Penicillin V | 500 mg by mouth two to three times daily | 10 days | First-line treatment for confirmed group A strep pharyngitis in adults without penicillin allergy |
| Amoxicillin | 500 mg by mouth twice daily | 10 days | Alternative first-line option for confirmed strep throat when penicillin V is not preferred |
| Cephalexin | 500 mg by mouth twice daily | 10 days | Option for adults with nonsevere penicillin allergy and confirmed or strongly suspected strep |
| Azithromycin | 500 mg by mouth on day 1, then 250 mg once daily | 5 days | Reserved for adults with severe beta-lactam allergy when treatment is indicated and local resistance patterns allow |
| Benzonatate | 100–200 mg by mouth up to three times daily | Short course during acute illness | For adults with associated dry cough that interferes with sleep or function, when safe and without contraindications |
TeleDirectMD does not prescribe controlled substances and does not prescribe antibiotics for clearly viral sore throats. All prescribing decisions follow adult pharyngitis guidelines when applicable and emphasize antibiotic stewardship.
Home Care, Monitoring, and Return to Work
Many adults with viral sore throat start to feel better over several days, while strep throat typically improves within 24–48 hours after appropriate antibiotics if indicated. Your TeleDirectMD physician will explain what to expect and when to escalate care.
- Use pain relievers as directed to keep throat pain manageable enough to drink fluids
- Maintain hydration with water, broths, and other nonirritating fluids
- Avoid smoking and irritating fumes that can worsen throat discomfort
- Monitor for new breathing difficulty, drooling, or rapidly worsening pain and seek urgent care if these occur
- Discuss timing of return to work based on diagnosis, fever resolution, and ability to perform duties
- Arrange follow-up with your usual clinician if symptoms are prolonged, recurrent, or atypical
Many adults can return to work once fever has resolved without fever-reducing medications, throat pain is improving, and they can swallow and speak comfortably enough to perform their job, while following workplace and public health guidance.
TeleDirectMD provides MD-only virtual urgent care for adults through secure video visits at a $49 flat-fee price point, available in 25+ states. We do not prescribe controlled substances and we follow evidence-based guidelines for every condition, including acute pharyngitis. Some situations require in-person evaluation, testing, or emergency care. Your TeleDirectMD physician will be clear about what telehealth can and cannot safely manage so you know what to expect.
Clinical content reviewed by Parth Bhavsar, MD.
Frequently Asked Questions about Online Sore Throat Treatment
For adults who are breathing comfortably, able to speak in full sentences, and can swallow liquids, telehealth is well suited for evaluating sore throat, assessing strep risk, and providing home care guidance. TeleDirectMD physicians identify red flags that require urgent in-person or emergency evaluation instead of virtual-only care.
We look at features such as sudden onset, fever, tender neck nodes, tonsillar exudates, and the absence of cough, along with your age and exposure history. This helps estimate your strep risk and decide whether in-person testing is needed. Viral symptoms like cough, congestion, and runny nose make strep less likely in most adults.
Clinical scoring systems help estimate the likelihood of strep, but confirmation usually requires a rapid strep test or throat culture performed in person. TeleDirectMD physicians use your risk level to advise when you should get local testing before starting antibiotics and will avoid routine antibiotics when the likelihood of strep is low.
No. Most adult sore throats are viral and improve with supportive care alone. Antibiotics are reserved for confirmed or strongly suspected strep throat. TeleDirectMD follows antibiotic stewardship principles to avoid unnecessary prescriptions that do not help viral infections and may cause side effects or resistance.
Many viral sore throats improve noticeably over three to five days. If pain is severe, persists beyond a week without improvement, or is accompanied by high fever, difficulty swallowing, or breathing problems, further in-person evaluation is recommended. TeleDirectMD helps you decide when the pattern is no longer consistent with a simple viral infection.
Hydration, warm saltwater gargles, throat lozenges, humidified air, and appropriate use of pain relievers can all help. Avoiding smoke and irritants is important. During your visit, TeleDirectMD physicians review which approaches are safe for you based on your health conditions and medications.
Red flags include drooling, difficulty breathing, stridor, severe trouble swallowing, muffled voice, significant neck or facial swelling, confusion, or rapidly worsening symptoms. These require emergency evaluation. TeleDirectMD physicians emphasize these warning signs and will direct you to in-person or ER care whenever virtual-only management is not safe.
When group A strep is confirmed and appropriate antibiotics are started, many adults notice improvement in throat pain and fever within 24–48 hours. It is still important to complete the full prescribed course to reduce the risk of complications and recurrence, even if you feel better sooner.
Most acute sore throats are infectious and self-limited. However, persistent throat symptoms, especially in smokers or those with additional warning signs such as weight loss or neck masses, may warrant further in-person evaluation. TeleDirectMD can help identify patterns that need referral to primary care or specialist evaluation for noninfectious causes.
TeleDirectMD is MD-only, uses a flat $49 fee, and operates in 25+ states with a focus on evidence-based care and antibiotic stewardship. Every visit is with a board-certified physician who clearly explains when telehealth is appropriate, when strep testing or antibiotics are indicated, and when in-person or emergency care is safer.