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A guideline that does not consider suppurative complications
Having studied adult sore throats for over 35 years, the recent use of corticosteroids seems strange. I do not understand this guideline. First, the sentence confounded me: "Most infections are of viral origin; only a few are caused by a bacterial infection, of which group A β-haemolytic streptococcus, Haemophilus influenzae, and Moraxella catarrhalis are the most common pathogens". I know of no data on either H. flu or Moraxella causing sore throats. They are causes of community acquired pneumonia. Group C strep and Fusobacterium necrophorum do cause sore throats in adolescents and young adults.
This error makes one wonder about the development of this guideline.
The evidence for corticosteroid use (as Dr. Linder makes clear ) is weak at best. While 1 dose likely will not cause and major side effects, it could mask worsening symptoms and delay diagnosis of suppurative complications. The benefits seem minimal.
This "guideline" is merely expert advice. It is really a guidance statement. I disagree with the guideline.
No competing interests
04 December 2017
Robert M Centor
FOT 720, 1530 3rd Ave S, Birmingham, AL 35294-3407