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Penicillin V and erythromycin do not improve voice disturbances in acute laryngitis in adults

Reveiz L, Cardona AF. Antibiotics for acute laryngitis in adults. Cochrane Database Syst Rev. 2013;3:CD004783.

Review question

How effective are antibiotics for acute laryngitis in adults?


Acute laryngitis is an inflammation of the larynx that lasts less than 3 weeks. The larynx is the voice box.

The most common symptoms are hoarseness or loss of voice, fever, sore throat, and phlegm (thick spit).

The goal of the usual treatment is to control symptoms. It includes voice rest, pain killers, and humidification. Physicians may also prescribe antibiotics, but usually viruses cause laryngitis and they do not respond to antibiotics.

How the review was done

This summary is based on a systematic review of 2 randomized controlled trials. They evaluated 2 different antibiotics for acute laryngitis in adults. Dates of the studies were 1985 and 1993.

In the first study, 100 people received either penicillin V (800 mg orally 2 times a day for 5 days) or an identical placebo.

In the second study, 106 people received either erythromycin (500 mg orally 2 times a day for 5 days) or an identical placebo.

Comparisons between treatment and placebo groups happened during the first visit, at re-examination after 1 and 2 weeks, and at follow-up after 2 to 6 months.

What the researchers found

PENICILLIN V—The voice scores did not differ between the penicillin V and placebo groups.

The rates of disease-causing germs also did not differ between the 2 groups at the acute and follow-up visits after 1 and 2 weeks.

ERYTHROMYCIN—The voice scores did not differ between the erythromycin and placebo groups.

The 2 groups did not differ in the recovery from disease-causing germs at 2 weeks.

ADVERSE DRUG REACTIONS—Neither the penicillin V trial nor the erythromycin trial reported any deaths. There were no reports of adverse drug effects either.

QUALITY OF EVIDENCE—The review included only 2 trials. They were small and judged to have a moderate risk of bias. Since they assessed different interventions, data aggregation was not possible.


Penicillin V and erythromycin showed no benefit in treating acute laryngitis.

Results for penicillin V or erythromycin versus placebo



Voice disturbance

No differences between antibiotics and placebo groups.

Rates of disease-causing germs

No difference between penicillin V and placebo groups.

Rate of recovery from disease-causing germs

No difference between erythromycin and placebo groups.

Adverse reactions

No deaths reported in either study.

Quality of evidence

Only 2 small studies reviewed.



A harmless, inactive, and simulated treatment.
Randomized controlled trials
Studies where people are assigned to one of the treatments purely by chance.
Risk of bias
Possibility of some systematic error in the studies.
Systematic review
A comprehensive evaluation of the available research evidence on a particular topic.

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