Corticosteroids for sore throat: a clinical practice guideline
BMJ 2017; 358 doi: https://doi.org/10.1136/bmj.j4090 (Published 20 September 2017) Cite this as: BMJ 2017;358:j4090Population
Choice of intervention
©BMJ Publishing Group Limited.
Disclaimer: This infographic is not a validated clinical decision aid. This information is provided without any representations, conditions or warranties that it is accurate or up to date. BMJ and its licensors assume no responsibility for any aspect of treatment administered with the aid of this information. Any reliance placed on this information is strictly at the user's own risk. For the full disclaimer wording see BMJ's terms and conditions: http://www.bmj.com/company/legal-information/
- Bert Aertgeerts, general practitioner, professor1 2,
- Thomas Agoritsas, general internist, assistant professor3 4,
- Reed A C Siemieniuk, general internist, methodologist3 5,
- Jako Burgers, general practitioner, professor6 7,
- Geertruida E Bekkering, methodologist1 2,
- Arnaud Merglen, pediatrician8,
- Mieke van Driel, general practitioner, professor9,
- Mieke Vermandere, general practitioner1,
- Dominique Bullens, paediatrician, professor10 11,
- Patrick Mbah Okwen, general practitioner12,
- Ricardo Niño, otorhinolaryngologist13,
- Ann van den Bruel, general practitioner, associate professor14 15,
- Lyubov Lytvyn, patient liaison expert16,
- Carla Berg-Nelson, patient representative17 18,
- Shunjie Chua, patient representative19,
- Jack Leahy, patient representative20,
- Jennifer Raven, patient representative21,
- Michael Weinberg, patient representative22,
- Behnam Sadeghirad, methodologist3 23,
- Per O Vandvik, general internist, associate professor15 24,
- Romina Brignardello-Petersen, methodologist and biostatistician2 25
- 1Academic Centre for General Practice, Department of Public Health and Primary Care, KU Leuven, Belgium
- 2CEBAM, Belgian Centre for Evidence-Based Medicine, Cochrane Belgium, Leuven, Belgium
- 3Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada L8S 4L8
- 4Division General Internal Medicine & Division of Clinical Epidemiology, University Hospitals of Geneva, CH-1211, Geneva, Switzerland
- 5Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- 6Dutch College of General Practitioners, Utrecht, The Netherlands
- 7School CAPHRI, Department Family Medicine, Maastricht, The Netherlands
- 8Division of General Pediatrics, University Hospitals of Geneva & Faculty of Medicine, University of Geneva, Geneva, Switzerland
- 9Primary Care Clinical Unit, Faculty of Medicine, University of Queensland, Brisbane, Australia
- 10Pediatric Immunology, Department of microbiology and immunology, KU Leuven, Belgium
- 11Pediatric allergy, Clinical division of pediatrics UZ Leuven, Leuven, Belgium
- 12Bali District Hospital, Bali and Centre for Development of Best practices in Health Yaounde, Cameroon
- 13Otorhinolaryngology—Head and Neck Surgery, Clinica del Country, Bogota, Colombia
- 14NIHR Oxford Diagnostic Evidence Cooperative, Oxford, UK
- 15Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
- 16Oslo University Hospital, Forskningsveien 2b, Blindern 0317 Oslo, Norway
- 17The Society for Participatory Medicine, Newburyport, MA 01950-1183, USA
- 18Arizona Senior Academy, Tucson, AZ 85747, USA
- 19MOH Holdings, 1 Maritime Square, Singapore, Singapore 099253
- 20Cochrane UK, London, UK
- 21Cochrane Consumers Group, Halifax, Canada
- 22Washington DC, USA
- 23HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
- 24Department of Medicine, Innlandet Hospital Trust - division Gjøvik, Norway
- 25Faculty of Dentistry, Universidad de Chile, Santiago, Chile
- Correspondence to: B Aertgeerts bert.aertgeerts{at}kuleuven.be
What you need to know:
Sore throat is one of the most common reasons for primary care appointments, and international guidance varies about whether to use corticosteroids to treat it, but a trial published in April 2017 suggested that costicosteroids might be effective
We make a weak recommendation to use a single dose of oral corticosteroids, in those presenting with acute sore throat, after performing a systematic review of the new evidence in this rapid recommendation publication package
The recommendation is weak and shared decision making is needed because corticosteroids did not help all patient reported outcomes and patients’ preferences varied substantially
Steroids somewhat reduced the severity and duration of pain by one day, but time off school or work was unchanged. Harm seems unlikely with one steroid dose.
The treatment is inexpensive and likely to be offered in the context of a consultation that would have taken place anyway
Box 1: Linked articles in this BMJ Rapid Recommendations cluster
Aertgeerts B, Agoritsas T, Siemieniuk RAC, …