Corticosteroids as standalone or add-on treatment for sore throat

Abstract

Cochrane Database of Systematic Reviews hours, pain (assessed by visual analogue scales) was reduced by an additional 10.6% by corticosteroids (moderate-certainty evidence). No di erences were reported in recurrence/relapse rates, days missed from work or school, or adverse events for participants taking corticosteroids compared to placebo. However, the reporting of adverse events was poor, and only two trials included children or reported days missed from work or school. The included studies were assessed as moderate quality evidence, but the small number of included studies has the potential to increase the uncertainty, particularly in terms of applying these results to children. Authors' conclusionsOral 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.

Do corticosteroids improve outcomes in peritonsillar abscess?

“…2 This may be less relevant, however, because their usage has been proven both efficacious and safe in cases of acute pharyngitis. 5 Overall, the literature supports the ability of corticosteroids to reduce the patients' perception of pain, reduce the length of stay, and augment an earlier return to normal activity compared with placebo. In both the RCTs rel-evant here, none of the 55 patients who were randomized to the steroid arms were reported to have experienced an adverse event from the single IV-dose regime, although follow-up may have been too short to reliably detect this.…”

Do corticosteroids improve outcomes in peritonsillar abscess?

“…2 This may be less relevant, however, because their usage has been proven both efficacious and safe in cases of acute pharyngitis. 5 Overall, the literature supports the ability of corticosteroids to reduce the patients' perception of pain, reduce the length of stay, and augment an earlier return to normal activity compared with placebo. In both the RCTs rel-evant here, none of the 55 patients who were randomized to the steroid arms were reported to have experienced an adverse event from the single IV-dose regime, although follow-up may have been too short to reliably detect this.…”

Effect of Oral Dexamethasone Without Immediate Antibiotics vs Placebo on Acute Sore Throat in Adults

“…12 A systematic review reported that participants with a sore throat, taking a single dose of steroid, were 3 times more likely to experience complete resolution within 24 hours. 13 However, antibiotics were prescribed to participants in both steroid and placebo groups in all trials and only 1 trial recruited participants from primary care. Therefore, evidence for corticosteroids for sore throat in primary care, in the absence of antibiotics, is still lacking.…”

Is the perceived placebo effect comparable between adults and children? A meta-regression analysis

“…Thirty-five reviews, including 179 trials with adult and 117 with pediatric participants, were finally analyzed (15, (Supplementary Table S1 online). From these reviews, 19 assessed the risk of bias (18,20,22,25,26,28,29,32,35,(37)(38)(39)(40)(41)44,46,(49)(50)(51), 6 reported only the Jadad score (15,19,21,36,45,48), 4 assessed only the allocation concealment (34,42,43,47), and 6 did not assess quality (23,24,27,30,31,33). Overall, 13 382 adult and 5 417 pediatric participants were enrolled in the placebo groups.…”

Do corticosteroids improve outcomes in peritonsillar abscess?

“…2 This may be less relevant, however, because their usage has been proven both efficacious and safe in cases of acute pharyngitis. 5 Overall, the literature supports the ability of corticosteroids to reduce the patients' perception of pain, reduce the length of stay, and augment an earlier return to normal activity compared with placebo. In both the RCTs rel-evant here, none of the 55 patients who were randomized to the steroid arms were reported to have experienced an adverse event from the single IV-dose regime, although follow-up may have been too short to reliably detect this.…”

Effect of Oral Dexamethasone Without Immediate Antibiotics vs Placebo on Acute Sore Throat in Adults

“…12 A systematic review reported that participants with a sore throat, taking a single dose of steroid, were 3 times more likely to experience complete resolution within 24 hours. 13 However, antibiotics were prescribed to participants in both steroid and placebo groups in all trials and only 1 trial recruited participants from primary care. Therefore, evidence for corticosteroids for sore throat in primary care, in the absence of antibiotics, is still lacking.…”

Is the perceived placebo effect comparable between adults and children? A meta-regression analysis

“…Thirty-five reviews, including 179 trials with adult and 117 with pediatric participants, were finally analyzed (15, (Supplementary Table S1 online). From these reviews, 19 assessed the risk of bias (18,20,22,25,26,28,29,32,35,(37)(38)(39)(40)(41)44,46,(49)(50)(51), 6 reported only the Jadad score (15,19,21,36,45,48), 4 assessed only the allocation concealment (34,42,43,47), and 6 did not assess quality (23,24,27,30,31,33). Overall, 13 382 adult and 5 417 pediatric participants were enrolled in the placebo groups.…”

Do corticosteroids improve outcomes in peritonsillar abscess?

“…2 This may be less relevant, however, because their usage has been proven both efficacious and safe in cases of acute pharyngitis. 5 Overall, the literature supports the ability of corticosteroids to reduce the patients' perception of pain, reduce the length of stay, and augment an earlier return to normal activity compared with placebo. In both the RCTs rel-evant here, none of the 55 patients who were randomized to the steroid arms were reported to have experienced an adverse event from the single IV-dose regime, although follow-up may have been too short to reliably detect this.…”

Effect of Oral Dexamethasone Without Immediate Antibiotics vs Placebo on Acute Sore Throat in Adults

“…12 A systematic review reported that participants with a sore throat, taking a single dose of steroid, were 3 times more likely to experience complete resolution within 24 hours. 13 However, antibiotics were prescribed to participants in both steroid and placebo groups in all trials and only 1 trial recruited participants from primary care. Therefore, evidence for corticosteroids for sore throat in primary care, in the absence of antibiotics, is still lacking.…”

Is the perceived placebo effect comparable between adults and children? A meta-regression analysis

“…Thirty-five reviews, including 179 trials with adult and 117 with pediatric participants, were finally analyzed (15, (Supplementary Table S1 online). From these reviews, 19 assessed the risk of bias (18,20,22,25,26,28,29,32,35,(37)(38)(39)(40)(41)44,46,(49)(50)(51), 6 reported only the Jadad score (15,19,21,36,45,48), 4 assessed only the allocation concealment (34,42,43,47), and 6 did not assess quality (23,24,27,30,31,33). Overall, 13 382 adult and 5 417 pediatric participants were enrolled in the placebo groups.…”