Corticosteroids as Standalone or Add-on Treatment for Sore Thoat
The article: Corticosteroids as standalone or add-on treatment for sore throat (A Cochrane Review). Hayward G et al 2014.
The goal: To assess the clnical benefit and safety of corticosteroids for symptoms of sore throat in adults and children.
The Study: They searched multiple databases to find randomised controlled trials that compared steroids to placebo or standard care in adults and children (>3 years of age) with sore throat. Studies that were excluded included those with patients who were hospitalized as inpatients, those wiht infectious mononucelosis, pts with sore throat following tonsilectomy/intubation/peritonsillar abscess. Note: all patients in all the trials included were given antibiotics for a presumed bacterial cause of sore throat.
1. Included 8 trials (743 patients)- all trials gave antibiotics to placebo and corticosteroid group, no trials assessed corticosteroids alone for sore throat
2. Corticosteroids increased the likelihood of complete resolution of pain at 24 hours by more than 3 times.
3. Fewere than four people need to be treated to prevent one person continuing to experience pain at 24 hours.
4. Steroids reduced mean time to onset of pain relief and mean time to complete resolution of pain, though significant heterogeneity was present.
5. No difference in rates of recurrence, relapse, or adverse events were reported for participants taking corticosteroids compared to placebo, although reporting of advere events was poor.
6. They did not compare different methods/dosing of corticosteroids, or study patients without antibiotics.
The takeaway: Oral or intramuscular corticosteroids, in addition to antibiotics, improve resolution of pain and onset of time to pain relief in patients with a sore throat. Corticosteroids did not have a significant number of adverse effects. However, studies were not included in this review of patients not being treated with antibiotics, children < 3 years old.