Corticosteroids for pain relief in sore throat: systematic review and meta-analysis

Hayward, Gail; Thompson, Matthew; Heneghan, Carl; Perera, Rafael; Del Mar, Chris; Glasziou, Paul

The eight studies included 743 patients (369 children, 374 adults): 348 (47%) had exudative sore throat, and 330 (44%) were positive for group A β-haemolytic streptococcus. Patients were recruited from emergency department and general practice settings in four countries: United States (five studies), Canada (one), Israel (one), and Turkey (one) (table 1). Corticosteroids used included betamethasone 2 ml (estimated dose 8 mg, one study), dexamethasone (up to 10 mg, six studies; or prednisone 60 mg, one study): doses were reasonably comparable for their potency. Corticosteroids were administered either intramuscularly (three studies), orally (four), or both (one). Six trials used one dose of corticosteroids, and two trials prescribed more than one dose of corticosteroids to a subgroup of participants.w1 w2 In the eight included studies, methodological quality was high with a low risk of bias (for example, all trials reported adequate allocation concealment and clear methods of randomisation). Table 2 reports the specific elements of methodological quality in the selected studies.