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Steroids speed sore throat recovery

A single dose of corticosteroids may help increase the rate of recovery in patients with painful sore throats, concludes a new analysis.

The Cochrane analysis of results from eight randomised trials of almost 750 adults and children showed those taking corticosteroids were three times more likely to have no pain 24 hours later.

The data showed that fewer than four people needed to be treated to prevent one person still having pain from a sore throat 24 hours after taking the drugs.

Corticosteroids also reduced the mean time to onset of pain relief and the mean time to complete resolution of pain by six and 14 hours, respectively.

The studies did not include any hospitalised patients, infectious mononucleosis, sore throat following tonsillectomy or intubation, or peritonsillar abscess.

The UK and Australian researchers admitted that antibiotics were used in most of the studies, so evidence was ‘lacking’ for the benefit of steroids alone.

One of the authors Dr Matthew Thompson, a GP in Oxford and a clinical researcher at the University of Oxford, said that while steroids are not widely used in the UK for sore throats, they are a powerful anti-inflammatory, and in small single doses are fairly safe.

He said: ‘The take-home message for GPs is that using a single dose of steroids in patients with sore throat seems to provide some therapeutic benefit.

Whilst recognising GPs would not want to encourage patients to see a GP every time they have a sore throat, he added: ‘But for a small subset, maybe those with a really sore throat, or who have something important at work or school or social occasion they really need to get better for, a single dose of steroids is an option.

‘Of course GPs still need to decide whether an antibiotic might help in patients with possible pyogenic strep, and to make sure there isn’t something else causing the sore throat.’

Dr Thompson said the National School for Primary Care Research is funding the TOAST (Treatment Options without Antibiotics for Sore Throat) Trial which looks at using a single dose of steroids rather than antibiotics in adults with sore throat. He hoped GPs will find this a useful study and help identify patients for the trial, starting in January.

Source: Cochrane Library, online 17 October

http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD008268.pub2/abstract

Readers' comments (4)

  • Bornjovial

    Apparently use of steroids in sore throat is common practice in Australia and NZ and those interested can see a thread regarding same in Doctors.net.uk. Although one has to note that many in the trial have been on Antibiotics at the same time at steroid and hence no one knows if a single dose steroid will worsen or push a Strep infection into sepsis. As sepsis is relatively rare one would need an extremely large sample size to prove that steroids don`t worsen a bacterial infection.

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  • Tom Caldwell

    So a self limiting condition may settle half a day sooner if we give steroids? Personally I think I would take the 14 hrs longer to resolution and no steroids

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  • Yes, why don't we encourage patients to flood the primary care with sore throat as they will benefit from steroid.

    What the researchers failed to mention was in other countries GP consultations are not free - hence the health care system can afford to spend GP time on such matter. In NHS - well you know the work load.....

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  • I always thought the vets did a better job than us- antibiotics and steroid shot for everything and anything when they see my dog- is that what we've come to?

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