A sore throat, also known as pharyngitis, is characterized by pain, scratchiness, or irritation in the throat, which often worsens when swallowing. The most common cause of a sore throat is a viral infection, such as a cold or the flu. Fortunately, viral sore throats typically resolve on their own without specific treatment. However, strep throat, a less common type of sore throat caused by bacteria, requires antibiotics to prevent complications. Other less frequent causes of sore throat may necessitate more complex treatment.
There are multiple lines of treatment for resolving symptoms. However one of them is controversial which is Corticosteroids:
AAfp based on a rapid review by BMJ recommendation says :
- Treatment Recommendations:
- First-line treatment: Acetaminophen or ibuprofen.
- Corticosteroids (single dose) may be considered based on a weak recommendation.
- Patient Criteria for Corticosteroid Recommendation:
- Patients at least five years old with severe or nonsevere sore throat.
- Excludes immunocompromised patients, those with infectious mononucleosis, recurrent sore throat, or sore throat after surgery or intubation.
- Effectiveness and Decision-Making:
- Corticosteroids increase pain resolution at 24 and 48 hours.
- They reduce pain severity and shorten the time to pain relief.
- However, they don’t significantly reduce recurrence or missed days from school/work.
- The decision to use corticosteroids should involve shared decision-making.
- Dosage and Risks:
- Typical dose: 10 mg dexamethasone for adults (0.6 mg/kg for children, up to 10 mg max).
- Risks may outweigh the benefits with larger doses in patients with multiple sore throat episodes.
A Chorane review concluded that:
Oral or intramuscular corticosteroids, in addition to antibiotics, moderately increased the likelihood of both resolution and improvement of pain in participants with sore throat. Given the limited benefit, further research into the harms and benefits of short courses of steroids is needed to permit informed decision‐making.
Resources:
https://www.aafp.org/pubs/afp/issues/2018/0615/p821.html
https://doi.org/10.1136/bmj.j4090
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD008268.pub3/full
