Benefit of steroids for sore throat still unclear

Using steroids, rather than antibiotics, for sore throat is marginally more effective after 48 hours, according to a randomised controlled trial.

Close up of sore throat or acute pharyngitis

Antibiotics are frequently prescribed inappropriately for sore throat in primary care. However, it has been suggested that corticosteroids could provide symptomatic relief and thereby reduce antibiotic use in sore throat.

In a study of 42 family practices in south and west England, published in JAMA
(online, 18 April 2017), 565 patients presenting with acute sore throat not requiring antibiotics were randomly assigned to a single oral dose of dexamethasone 10mg or placebo.

The researchers found that there was no difference in the number of patients achieving the primary endpoint, complete resolution of symptoms at 24 hours (22.6 vs 17.7%, respectively). However, at 48 hours the difference between the groups was significant with more in the dexamethasone group experiencing complete resolution than those taking placebo (35.4 vs 27.1%).

Uncertainty remains about the role of corticosteroids in the treatment of sore throat in primary care, the team concludes.


[1] Hayward GN, Hay AD, Moore MV, et al. Effect of oral dexamethasone without immediate antibiotics vs placebo on acute sore throat in adults: a randomized clinical trial. JAMA 2017; 317; 1535-1543. doi: 10.1001/jama.2017.3417

Last updated
Clinical Pharmacist, CP, June 2017, Vol 9, No 6;9(6):DOI:10.1211/PJ.2017.20202693

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