Upper Respiratory Tract Infection: Your GoodRx Guide

Definition

An upper respiratory tract infection (URTI) is when you get an infection in your upper airways. If you’ve ever had feelings of congestion, runny nose, sore throat, and head pressure, then you’ve probably had an URTI.  

The upper respiratory tract is made up of the nose, sinuses, throat, and larynx (voice box). An URTI happens when any of these areas develop an infection. 

Here are some different types of URTIs:

• Sinusitis is an infection that causes inflammation in the sinuses.

• Common colds are an infection that cause inflammation in the nose and throat.

• Pharyngitis is an infection that causes inflammation in the throat.

• Laryngitis is an infection that causes inflammation in the larynx.

You can get infections in the lower respiratory tract, too. These happen when germs infect the lower airways. Examples of lower respiratory tract infections include bronchitis and pneumonia. 

Most of the time, URTIs will go away on their own. But it’s helpful to know what causes them, how to treat them, and when to get medical attention for your symptoms. 

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Causes

URTIs are mostly caused by viruses, and occasionally by bacteria. These germs can easily spread from person to person — especially in colder months. Typically, germs are spread by sharing droplets of saliva, nasal secretions, or respiratory droplets with a person who is infected. This can happen through coughing, sneezing, talking, and poor hand hygiene. 

Here are some common viruses that cause URTIs:

• Rhinovirus (causes up to 80% of URTIs during peak season) 

• Influenza

• COVID-19

• Coronaviruses (other than COVID) 

• Adenovirus

• Respiratory syncytial virus (RSV)

• Enterovirus

URTIs are less likely to be bacterial. That said, strep throat is a common bacterial URTI. It’s caused by group A streptococcus bacteria. 

Some people are more likely to get an URTI. This includes:

• Children in day care or school, or people exposed to those children

• People with asthma or allergic rhinitis

• People who smoke

• Someone who is immunocompromised 

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Symptoms

The most common symptoms are cough, nasal congestion, and fatigue. Beyond that, specific URTI symptoms depend on which part of your upper respiratory tract is affected. 

Typical symptoms of the common cold include:

• Cough

• Runny nose

• Nasal congestion

• Sneezing

Sinusitis symptoms include:

• Headache

• Facial pain

• Nasal congestion or runny nose

Pharyngitis symptoms include:

• Sore or dry throat

• Pain with swallowing

• Cough

• Bad breath

Laryngitis symptoms include:

• Hoarse voice or loss of voice

• Sore throat

• Dry cough

These symptoms can overlap. And a common cold can turn into a sinus infection, and a virus can cause both pharyngitis and laryngitis symptoms. 

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Diagnosis

Symptoms are usually enough to diagnose an upper respiratory tract infection. If you see a healthcare provider, they will start by asking about your symptoms. 

Next, a physical exam will help them figure out what’s going on. They may look in your nose, mouth, and throat. And they’ll listen to your lungs. Often they can make the diagnosis without doing further tests. 

But, in some cases, testing can be helpful. Your healthcare provider may want to order testing to identify a: 

• Bacterial versus viral infection: For example, a throat swab can test for strep bacteria to figure out if antibiotics are needed for a sore throat. 

• Specific virus that could be treated: For example, a positive test for flu or COVID can open up different options for treatment. 

Usually you don’t need to get a diagnosis for the specific type of URTI you have. That’s because most viral URTIs get better on their own, and a diagnosis doesn’t change treatment. 

But sometimes you do need to see (or talk with) a healthcare provider. For example:

• You have severe symptoms like difficulty breathing, fevers that won’t go down, or you are dehydrated.

• You are immunocompromised or have significant chronic medical conditions.

• You aren’t getting better with home remedies after 7 days.

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Treatments

Since most URTIs are caused by viruses, antibiotics aren’t usually necessary or helpful. Treatment involves making yourself comfortable, getting plenty of rest, and staying hydrated. And, last but not least, make sure to give your body time to recover.  

Home remedies can also be helpful. At-home treatments can include: 

• Drinking hot tea

• Adding honey to a warm drink, or taking a spoonful of honey on its own

• Using extra pillows at night to help your body drain mucus better

• Using a saline wash with neti pot

• Creating a steam bath in the shower or bath 

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Medications

Sometimes at-home remedies just aren’t enough to help your symptoms, and you may need medications.

Over-the-counter cold and flu medications

There are helpful over-the-counter medications that can help you feel more comfortable as your body fights off the infection. These include: 

• Decongestants: such as nasal sprays or pseudoephedrine (Sudafed)

• Pain relievers: like ibuprofen (Advil) and acetaminophen (Tylenol)

• Cough medicine: depending on the type of cough

Flu and COVID treatments

Depending on the cause of your URTI or your risk for severe flu or COVID illness, your healthcare provider may prescribe medications to treat influenza or COVID. For example: 

• Flu treatments: like oseltamivir (Tamiflu) or baloxavir marboxil (Xofluza)

• COVID treatments: like nirmatrelvir and ritonavir (Paxlovid), molnupiravir (Lagevrio), or other medications  

Antibiotics

Infections caused by bacteria need treatment with antibiotics. If your healthcare provider determines that your URTI could be caused by a bacteria, they will usually prescribe an antibiotic. In those cases: 

• Bacterial sinusitis is often treated with amoxicillin or amoxicillin / clavulanate (Augmentin). 

• Strep throat is usually treated with amoxicillin. 

Other antibiotic options are available for those with penicillin allergies.

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