Thursday 27 August 2009

Use of Corticosteroids in Sore Throat

What is already known on this topic

Corticosteroids are beneficial for symptoms of upper respiratory tract infections
Sore throat is a common condition in primary care
Recent guidelines recommend that antibiotics should not be prescribed for sore throat

What this study adds

At 24 hours, patients with severe sore throat who are given corticosteroids in addition to antibiotics are three times more likely to report complete resolution of symptoms than those who do not receive corticosteroids
Corticosteroids also reduce the time to mean onset of pain relief in this patient group by about 6 hours
The effect of corticosteroids independent of antibiotics is unknown and should be the focus of future research
Published 6 August 2009, doi:10.1136/bmj.b2976
Cite this as: BMJ 2009;339:b2976


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Comments
I think this study vindicates what I have felt for a long time, that a short course of steroids ( single shot, or max 3-5 days which does not need tapering)when used judiciously, significantly reduces mordbiditry and improves resolution.The side effects for such short term use are usually acceptable. I had mentioned this in treatment of Barotrauma, to enable cabin crew/flyers to get back to their jobs farster, but a lot of people were critical of this.

I just hope that this is not misused/overused, the way antibiotics have been.
Dr Ajit Mansingh (Max Hospital , Delhi)

We already know that post-op pain in tonsillectomy is much less if a single intraoperative dose of a steroid is used. So this concept of using steroid in tonsillitis does not sound too alien. however it also makes one wonder if our GP brethren who have been using steroids (mixing antibiotic powder crushed together with steroid)quoting their experiences knew better all along. Another factor to be considered is the reluctance of the population in general to using anything which has anything to do with steroids.
Dr.Atul Ahuja,Delhi


I think the steroids if given after the fever has gone and more over if steroids in mild dose are kept in oral cavity for some time before being swallowed are more useful
Dr P.S.Jassal

3 comments:

  1. We already know that post-op pain in tonsillectomy is much less if a single intraoperative dose of a steroid is used. So this concept of using steroid in tonsillitis does not sound too alien. however it also makes one wonder if our GP brethren who have been using steroids (mixing antibiotic powder crushed together with steroid)quoting their experiences knew better all along. Another factor to be considered is the reluctance of the population in general to using anything which has anything to do with steroids.
    Dr.Atul Ahuja

    ReplyDelete
  2. I think the steroids if given after the fever has gone and more over if steroids in mild dose are kept in oral cavity for some time before being swallowed are more useful

    ReplyDelete
  3. i've never used steroids in this scenario but have found them being prescribed by many physicians, albeit for few days. this study advocates a single dose administration, either oral or injectable. i feel this study will help us in judiciously using steroids in sore throat. many thanks to the uploader of this topic.
    Dr Harpreet S Kochar

    http://www.sciencedaily.com/releases/2002/01/020103074708.html

    http://www.nlm.nih.gov/medlineplus/news/fullstory_87886.html

    ReplyDelete