Short courses of steroids may be beneficial to treat sore throat. This is an update of our review. We added one new trial participants for a total nine trials involving participants children, adults. The included trials were conducted in emergency department 7 trials and primary care 2 trials settings in the USA 5 trials , and one trial each in Canada, Israel, Turkey, and the UK.
Participants received either a single dose of steroids or a single dose of a dummy drug placebo 7 trials. More than one consecutive daily dose of steroid or placebo was given to one group of participants, whilst the other group received a single dose 2 trials. In eight trials all participants also received antibiotics immediately on entry to the study. All trials were published in English. Participants who received corticosteroids were 2.
Corticosteroids improved times to both start symptom relief and to completely resolve symptoms, although trial evidence was not consistent for these outcomes, and effects were modest. Sore throats are very common in children, but only two trials reported results for children, and these results were inconsistent, making it difficult to draw conclusions. Further research is therefore needed to examine the benefits of corticosteroids for both reducing antibiotic use in people with severe sore throat, and the benefit for children specifically.
Limitations were that only two trials included children and that most trials also gave antibiotics to all participants. Oral or intramuscular corticosteroids, in addition to antibiotics, moderately increased the likelihood of both resolution and improvement of pain in participants with sore throat. Given the limited benefit, further research into the harms and benefits of short courses of steroids is needed to permit informed decision-making.
Sore throat is a common condition associated with a high rate of antibiotic prescriptions, despite limited evidence for the effectiveness of antibiotics. Corticosteroids may improve symptoms of sore throat by reducing inflammation of the upper respiratory tract. This review is an update to our review published in To assess the clinical benefit and safety of corticosteroids in reducing the symptoms of sore throat in adults and children.
We included randomised controlled trials RCTs that compared steroids to either placebo or standard care in adults and children aged over three years with sore throat. We excluded studies of hospitalised participants, those with infectious mononucleosis glandular fever , sore throat following tonsillectomy or intubation, or peritonsillar abscess.
We included one new RCT in this update, for a total of nine trials involving participants children and adults. In eight trials, participants in both corticosteroid and placebo groups received antibiotics; one trial offered delayed prescription of antibiotics based on clinical assessment. Only two trials reported funding sources government and a university foundation. In addition to any effect of antibiotics and analgesia, corticosteroids increased the likelihood of complete resolution of pain at 24 hours by 2.
The team reports in the journal Academic Emergency Medicine that corticosteroids hastened pain relief by about four and a half hours, on average. Patients taking them had less pain - about one point on a scale of 0 to ten - 24 hours later. For those with known strep throat, steroids worked more quickly, bringing pain relief about 45 minutes sooner. None of the studies in this analysis reported any serious problems associated with steroid use. However, repeated steroid use can have serious side effects, such as weaker bones, Rowe added, noting that many people may get several sore throats a year -- meaning they could wind up getting a lot of steroids.
Short-term effects of steroids include swelling, stomach irritation, and restlessness.
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