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Independents' Day

NSAID 'an alternative to antibiotics' in sore throat

GPs should consider the NSAID flurbiprofen as an alternative treatment to antibiotics for patients with upper respiratory tract infections (URTIs), say researchers.

The study

Australian and UK researchers randomised 346 patients with sore throat due to an URTI to receive either 8.75mg flurbiprofen or placebo. All patients were aged 18 to 75 years and had a sore throat with an onset of four days or less. After receiving either flurbiprofen or placebo, patients were assessed in clinic one minute before the first dose, one minute after, at five minute intervals up to 15 minutes, then at 15-minute intervals up to 180 minutes, and hourly from then on up to 360 minutes. Throat soreness was assessed on an 11-point ordinal scale.

The findings

The area under the curve for severity of throat soreness was significant for those who received flurbiprofen over the first two hours, compared with placebo (-2.29 and -1.81, respectively). In addition sore throat relief, as measured on a seven-point sore throat relief scale, was significantly greater in those who took flurbiprofen compared to placebo at the end of day one and day three post-dose, with a difference of the area under the curve of 0.42 and 0.38 respectively.

What does it mean for GPs?

The authors concluded that flurbiprofen ‘provides GPs with an alternative treatment to antibiotic therapy’. They said GPs following NICE’s strategy of no, or delayed, antibiotic prescribing should consider recommending suitable over-the-counter treatments for patients presenting with sore throat.

BJGP 2013, available online 28 January

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