Penicillin V and erythromycin have no benefit for most adults with acute laryngitis

Two common antibiotics, Penicillin V and erythromycin, appear to have no benefit for most adults with acute laryngitis, says a research team led by Dr. Ludovic Reveiz of Bogota, Colombia.

Arguments against prescribing antibiotics include cost, adverse side effects and possible contribution to antibiotic resistance. The authors reviewed existing scientific literature and cautioned that definitive recommendations cannot be made because solid results are available from only two randomized controlled trials, studies with the highest standard of evidence.

Acute infectious laryngitis is usually caused by viral infection; however, bacterial pathogens can often be isolated in patients as well. Upper respiratory tract infections represent a frequent reason for prescribing antibiotics in ambulatory practice and primary care, the authors say.

In each study, approximately 100 adult laryngitis patients received either antibiotic or a placebo. Repeated voice recordings provided an objective measure of symptoms, and no significant differences were found between the groups.

“These findings support the conclusion that the disorder is generally self-limiting, and maybe the majority of patients in the studies were suffering from viral [infections].”

Additional research should examine the role of bacterial infection in acute laryngitis, say the authors. Any subsequent increases in antibiotic resistance should also be described.