Sore throat in primary care

BMJ 2009; 339 doi: http://dx.doi.org/10.1136/bmj.b2476 (Published 06 August 2009) Cite this as: BMJ 2009;339:b2476
  1. Paul Little, professor of primary care research
  1. 1University of Southampton, Southampton SO16 5ST
  1. P.Little{at}soton.ac.uk

    Steroids reduce pain in the first day, but data on harms are lacking

    In the linked study (doi:10.1136/bmj.b2976), Hayward and colleagues report a useful and well performed systematic review in a highly topical area.1 Clinicians and patients need information about interventions other than antibiotics for sore throat for several reasons—the benefit of antibiotics for most patients is modest2 3; the use of antibiotics should be minimised because of the danger of resistance3 4; and other effective treatments, apart from the use of analgesics, anti-inflammatory drugs,5 and possibly Echinacea, are lacking.6 This systematic review provides evidence that in the first 24 hours steroids may help resolve pain (the likelihood of resolution was increased threefold, number needed to treat (NNT) 3.7) and reduce the mean time to onset of pain relief by six hours. Furthermore, given that most patients in the included studies had antibiotics, although …

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