One dose of corticosteroid can reduce the severity of acute sore throat without antibiotics, an international review has found
One dose of corticosteroid can reduce the severity and duration of acute sore throat without the use of antibiotics, an international evidence review has found.
Professor Mieke van Driel, Chair of General Practice at the University of Queensland, was part of an expert committee tasked with reviewing studies of corticosteroids’ effectiveness in providing relief from the condition.
They concluded that a single dose of corticosteroid sped up pain relief in most patients, including children as young as five years, by about one day.
Current Australian guidelines, from 2014, advise corticosteroids can be effective as an adjunct to antibiotics and only for adults.
Professor van Driel said sore throat in general could be caused by a variety of viruses as well as bacteria, and the steroid treatment could avoid unnecessary use of antibiotics.
“We don’t really have a lot of options, especially if people have severe pain and their tonsils are swollen, and they feel like they can’t eat and drink,” she told The Medical Republic.
Simple pain-relief medications such as paracetamol or ibuprofen would often not be enough for people in severe discomfort, Professor van Driel said.
“This gives us another option. It’s a very simple treatment, it’s one-off. What we have seen in the studies is there are no reported side-effects to be cautious about.”
The treatment could be given in a general practice and the patient told to come back if the condition persisted, she said.
The advice has been published in the British Medical Journal’s Rapid Recommendations series, which aims to give clinicians quick access to helpful research findings.
The systematic review looked at 10 studies of patients in hospital emergency rooms and primary care settings, including five studies conducted in the US and others in Canada, South Korea, Israel, Turkey and the UK.
Acute sore throat was a self-limiting disease that typically resolves after seven to 10 days in adults and two to seven days in children.
The expert committee’s report recommended a dose of 10mg of dexamethasone, or an alternative, for adult patients with acute sore throat.
The recommendation does not apply to children under five years as none were included in the studies.
The treatment is not applicable to patients with infectious mononucleosis, immunocompromising conditions and sore throat following surgery or intubation.
