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Corticosteroids for Sore Throat: BMJ Rapid Recommendation | AAFP |
Prednisone sore throat. Corticosteroids as stand-alone or add-on treatment for sore throat
Prednisone sore throat
- Prednisone sore throat
This Cochrane review found that patients with severe or exudative sore throat benefit from pain reduction with corticosteroids, used as an adjunct to antibiotics and other analgesics without increased risk for harm. Nonetheless, the use of steroids in this patient population would address a practical concern of those seeking symptom relief and has the potential to decrease unnecessary use of antibiotics.
CAVEATS Questions about effects on antibiotic use, heterogeneity The studies in this meta-analysis did not assess whether the use of corticosteroids would reduce unnecessary use of antibiotics, so we cannot conclude that this would be the case.
Because the effect was similar in all subgroups analyzed, however, it is reasonable to expect that reduced antibiotic use could be a positive effect. The main documented benefit was resolution of pain, an important patient-centered outcome that justifies consideration of treating painful pharyngitis with corticosteroids. Skip to main content. Corticosteroids for a Sore Throat? Background information in the article describes how corticosteroids inhibit transcription of proinflammatory mediators in airway endothelial cells, which are responsible for pharyngeal inflammation and pain symptoms.
In the study, Treatment Options Without Antibiotics for Sore Throat TOAST , the primary objective was to determine whether adults with acute sore throat not requiring immediate antibiotic therapy would experience one-day symptom reduction with a single dose of oral dexamethasone versus placebo. Results indicate that, at 24 hours, A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference.
This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. From the AFP Editors. Guideline source: BMJ. Evidence rating system used? Systematic literature search described? Guideline developed by participants without relevant financial ties to industry? Recommendations based on patient-oriented outcomes?
Published source: BMJ. Gail Hayward. In the face of mounting pressure to reduce antibiotic prescribing, what alternatives are there for treating the one-in-ten people who visit their doctor each year with this common ailment? As both a GP and an academic researcher, I see a lot of patients who are suffering with sore throats, and I know that effective alternative treatments to antibiotics would be welcomed by both GPs and patients.
While previous research on the subject has suggested a role for corticosteroids, the evidence is yet to be compelling enough to herald a step-change in our approach to acute sore throat. So along with researchers from the Universities of Oxford, Bristol and Southampton, we set out to shed some light on the issue by examining, for the first time, the effect of a single corticosteroid capsule given to patients in primary care who present with a sore throat.
We followed up by text message to find out whether patients were feeling completely better, how long they had moderately bad symptoms for, whether they had time off work, and if they had cashed-in the antibiotic prescription. After 24 hours, corticosteroids had no effect on sore throat symptoms compared with the control group.
One dose of a steroid can alleviate the pain—and has the potential to decrease unnecessary use of antibiotics. She has no associated cough. Examination reveals erythematous posterior oropharynx with exudate.
A rapid strep test is negative. The patient says the sore throat is very painful and asks for medication to make it better.
What should you prescribe? Most sore throats—particularly in adults—are viral and self-limiting. Do patients want antibiotics, or simply pain relief? Antibiotics produce only a modest reduction in symptoms of pharyngitis fever and throat sorenesspresumably in patients with bacterial infections, and increase the risk for adverse events. A short course of corticosteroids has been used successfully and shown to be safe for conditions such as acute sinusitis, croup, and asthma.
A systematic review suggested that was the case. In all eight RCTs, antibiotics were given to those in both the treatment and placebo groups. In addition, all participants were allowed to use traditional analgesia either acetaminophen or NSAIDs. Corticosteroids oral dexamethasone, oral prednisone, or intramuscular [IM] dexamethasone were used as an adjunctive treatment in all the RCTs.
Primary outcomes varied between studies. Four of the eight RCTs included the proportion of patients with improvement or complete resolution of symptoms within 24 to 48 hours. Mean time to onset of pain relief was the primary outcome in five of the eight studies.
Some of the secondary outcomes in the individual trials included relapse rates, adverse events, and days missed from school or work. This Cochrane review found that patients with severe or exudative sore throat benefit from pain reduction with corticosteroids, used as an adjunct to antibiotics and other analgesics without increased risk for harm. Nonetheless, the use of steroids in this patient population would address a practical concern of those seeking symptom relief and has the potential to decrease unnecessary use of antibiotics.
CAVEATS Questions about effects on antibiotic use, heterogeneity The studies in this meta-analysis did not assess whether the use of corticosteroids would reduce unnecessary use of antibiotics, so we cannot conclude that this would be the case. Because the effect was similar in all subgroups analyzed, however, it is reasonable to expect that reduced antibiotic use could be a positive effect.
The main documented benefit was resolution of pain, an important patient-centered outcome that justifies consideration of treating painful pharyngitis with corticosteroids.
Skip to main content. Corticosteroids for a Sore Throat? Clinician Reviews. Pages 1 2 last ». Next Article: Herpes Zoster Infection. Infectious Diseases.
Physicians may prescribe antibiotics for sore throats, although they have no Similar steroids include prednisone and methylprednisolone. Steroids are not currently recommended for routine use to treat symptoms of sore throat. This Cochrane review found that patients with severe or exudative sore. Sore throat is one of the most common reasons for primary care appointments, and international guidance varies about whether to use. Single-dose corticosteroids may be used to resolve sore throat symptoms at 48 hours in patients five years and older. Conclusion Single low dose corticosteroids can provide pain relief in patients with sore throat, with no increase in serious adverse effects. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. All Rights Reserved. In all eight RCTs, antibiotics were given to those in both the treatment and placebo groups. Next Article: Herpes Zoster Infection. Readers' comments will be moderated - see our guidelines for further information.Featured Issue Featured Supplements. Oxford, U. The answer is mixed, according to a new study appearing in JAMA. University of Oxford—led researchers determined that, as of 24 hours, patients at 42 family practices in South and West England who received dexamethasone had complete symptom resolution at no higher rates than those getting a placebo. At 48 hours, however, more participants receiving dexamethasone than placebo reported complete symptom resolution, whether or not they were offered delayed antibiotics.
Background information in the article describes how corticosteroids inhibit transcription of proinflammatory mediators in airway endothelial cells, which are responsible for pharyngeal inflammation and pain symptoms. In the study, Treatment Options Without Antibiotics for Sore Throat TOAST , the primary objective was to determine whether adults with acute sore throat not requiring immediate antibiotic therapy would experience one-day symptom reduction with a single dose of oral dexamethasone versus placebo.
Results indicate that, at 24 hours, At 48 hours, Results also indicate that, in participants not offered delayed antibiotic prescription, the risk difference was In the U. Related Content. All rights reserved.
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