Patient with sore throat at outpatient appointment

Background. Sore throat is one of the most common complaints when patients visit a medical facility. There are many possible causes of sore throat: herpangina, infectious mononucleosis, candidal stomatitis, lacunar and follicular tonsillitis, diphtheria, paratonsillar abscess, and a number of other diseases. However, doctors most often encounter tonsillopharyngitis, usually of viral, less often of bacterial etiology. The effectiveness of working with a patient directly depends on the professionalism of the doctor: the breadth of their clinical thinking, their ability to ask the patient questions, conduct a physical examination, and perform instrumental examinations. In the latter case, a correctly performed pharyngoscopy is extremely important, as it allows you to identify the characteristic signs of the disease and conduct a differential diagnosis. The main issues determining the doctor's treatment strategy are the appropriateness of prescribing antibacterial drugs and the choice of symptomatic treatment. Given that the disease is most often viral in origin, antibiotics should not be used in the first days of treatment until the causes of the disease have been clarified. Antibiotics are only justified in cases of verified bacterial infection, namely group A β-hemolytic streptococcus (GABHS). The optimal choice for acute GABHS infection is amoxicillin, and for recurrent infection, amoxicillin/clavulanate. Adequate symptomatic therapy can resolve the problem of sore throat regardless of its etiology. Nonsteroidal anti-inflammatory drugs and analgesics/antipyretics are usually prescribed: systemic and topical. Systemic drugs effectively relieve fever and significantly reduce the severity of sore throat. However, topical drugs are more effective. One of the most effective active ingredients in this group is flurbiprofen, which is available in the form of lozenges. The drug is a derivative of propionic acid, and its mechanism of action is associated with the inhibition of cyclooxygenase and the suppression of the synthesis of pro-inflammatory prostaglandins, which cause the development of the disease. Flurbiprofen has the mildest effect on the affected mucous membrane of the pharynx and is able to suppress the inflammatory process caused by both viruses and bacteria. It quickly penetrates tissues, including deep layers, and has a pronounced analgesic and anti-inflammatory effect on the mucous membrane of the oral cavity and pharynx.

Conclusion. Issues related to the diagnosis and treatment of patients with sore throat in outpatient therapeutic practice are considered. The most common causes of sore throat, physical, laboratory, and instrumental diagnostics are discussed. Criteria for prescribing antibiotic therapy for infectious etiology of the disease are outlined. Emphasis is placed on symptomatic treatment and the use of topical preparations. The effectiveness of flurbiprofen in rapidly relieving pain and reducing inflammation is demonstrated.

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