How do you cure acute pharyngitis? I've taken Bactrim and Darvocet, but nothing seems to help.

H.C.

Acute pharyngitis is nothing more than a sore throat. The diagnosis usually implies infection with either a virus or bacterium, but really indicates throat inflammation for any reason. "Acute" indicates that the problem has not been around for very long (less than two or three weeks); otherwise, your doctor would have used either the term subacute or chronic. "Pharyngitis" indicates inflammation (itis) of the throat (pharynx).
To cure acute pharyngitis, you need to do two things: eliminate the agent that is causing (or perpetuating) the inflammation, and take steps to improve the health of the lining of the throat (mucosa). Let's consider each of these in turn.

1. Eliminate the agent that is causing (or perpetuating) the inflammation. If you have a viral infection, you'll just have to wait it out. Antibiotics (such as Bactrim) are effective only against bacterial infections, and there are no antiviral medications available for most of the viruses that cause sore throat. Give it time; your immune system will get the upper hand, and you'll get better. If you have a bacterial infection, then antibiotics may help -- if your bacteria are susceptible (not resistant) to the antibiotic that was chosen. If your bacteria are resistant, then you might need a different antibiotic. Although this is an unlikely situation, it is certainly not impossible.

If you are infected with something that is neither virus nor bacteria (for example, if you are infected with the yeast Candida, which causes thrush), then antibiotics would not be helpful; you would need medication specific for your particular infection.

How about eliminating factors that perpetuate inflammation? The most common irritants would be tobacco smoke (primary or secondhand) and alcohol (present not just in alcoholic beverages, but also in most commercially available mouthwashes). Other potential irritants would be stomach acid and digestive enzymes -- which can enter the throat in people with gastroesophageal reflux disease -- and chemical fumes (solvents, paint fumes, cleaning fluids, smog and so forth). If your diet is rich in heavily salted, spiced or acidic foods, then this too could be to blame for a prolonged recovery.

2. Take steps to improve the health of the lining of the throat (mucosa). In addition to eliminating irritants, you can do something very simple to help your throat: Gargle with warm saltwater. My favorite recipe is two teaspoons of table salt, one teaspoon of baking soda (sodium bicarbonate) and one pint of water. Dissolve the dry ingredients in the water and store in a clean container. Use it at a temperature somewhat warmer than body temperature (NOT scalding -- that would be a big step in the wrong direction!). Do a "deep gargle" with this solution two or three times each day until your symptoms resolve. Make up a fresh batch every few days, since microorganisms can grow even in this very nutrient-poor environment.

If your symptoms persist for more than three weeks, you need to see your doctor -- and it certainly wouldn't be a bad idea to see an ear, nose and throat specialist. Persistent throat pain can be a sign of a more serious problem -- even cancer -- so if the conservative measures described above fail to give you prompt relief, you must seek medical attention.