Corticosteroids Hasten Pain Relief in Patients with Sore Throat

Evidence suggests that corticosteroid treatment relieves pain in patients with sore throats (NEJM JW Gen Med Jun 1 2017 and JAMA 2017; 317:1535). In this systematic review and meta-analysis, researchers determined benefits and harms of adding corticosteroids to standard clinical care of children and adults (age, ≥5 years) with clinical signs of acute tonsillitis, pharyngitis, or clinical syndrome of sore throat who presented to emergency departments or primary care.

Researchers evaluated 10 randomized controlled trials (1426 patients) in which corticosteroids were compared with placebo or standard care. Single-dose oral dexamethasone was the most common intervention (10 mg for adults; 0.6 mg/kg [maximum, 10 mg] for children). Protocols for antibiotic and analgesic use varied among trials. Patients who received corticosteroids were significantly more likely to experience complete resolution of pain after 24 and 48 hours than were controls. Mean time to onset of pain relief was 5 hours sooner and mean time to complete resolution of pain was 11 hours sooner in participants who received corticosteroids than in controls. Adverse events were similar in corticosteroid and noncorticosteroid groups.