steroids and sore throat

25 Jan
(scroll to bottom for 10-second version)
REVIEW ARTICLE:
–includes 5 adult trials of IM vs oral steroids for acute pharyngitis
–suggested earlier reduction of pain and shorter time to complete relief as well as 3 pediatric trials using oral dex (0.6 mg/kg to a max of 10 mg) as a single dose or given over 3 days showed earlier pain reduction compared to controls
no benefit to 3 day vs. single dose
META-ANALYSIS:
–includes 8 RCT’s comparing systemic corticosteroids and placebo
–when given with antibiotics, patients who received steroids had an average onset of pain relief 6.3 hours earlier
INTRAMUSCULAR STEROIDS:
–turkish study; single dose IM dex vs. placebo for patients with 2+ Centor criteria
average onset to pain relief of 8.1 hrs in steroid group vs. 19.9 hrs in placebo group
complete pain relief of 28.9 hrs (steroid) vs 53.7 hrs (placebo)
PO vs. IM STEROIDS:
–single dose oral prednisone vs IM dexamethasone
no difference in pain scores or number of hours to relief of pain
10-SECOND RECAP:
steroids in acute pharyngitis: hastens pain relief by about 6-24 hours (vs. placebo)
single dose probably just as good as 3-day course
dexamethasone IM vs. prednisone PO: works about the same
Submitted by F. DiFranco.
Reference(s): Hayward, G., et al. Corticosteroids for pain relief in sore throat: systematic review and meta-analysis. British Medical Journal. 339:b2976, Aug. 2009; Korb, K., et al. Steroids as adjuvant therapy for acute pharyngitis in ambulatory patients: a systematic review. Annals of Family Medicine. 8(1):58, Jan.-Feb. 2010; Marvez-Valls, E., et al. A randomized clinical trial of oral versus intramuscular delivery of steroids in acute exudative pharyngitis. Academic Emergency Medicine. 9(1):1, Jan. 2002; Tasar, A., et al. Clinical efficacy of dexamethasone for acute exudative pharyngitis. Journal of Emergency Medicine. 35(4):363, Nov. 2008; picture
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