Got a bad sore throat? Don't rush to ask your doctor for steroids such as prednisone, says a new review of studies.
There's been "a bit of a push" to use corticosteroids to treat sore throats based on the drugs' inflammation-quelling powers, study co-author Dr. Brian H. Rowe of the University of Alberta in Edmonton told Reuters Health, but not much evidence as to whether they help.
Steroids, given by mouth or by injection, are powerful drugs with short- and long-term side effects, he said, so they shouldn't be prescribed unless there's clear evidence that their benefits outweigh the risks.
To investigate, he and his colleagues searched the medical literature and came up with 10 "gold standard" clinical studies comparing corticosteroids — with or without antibiotics — to inactive placebo or standard treatment in patients with sore throat. The studies included nearly 1,100 patients.
The team reports in the journal Academic Emergency Medicine that corticosteroids hastened pain relief by about four and a half hours, on average. Patients taking them had less pain — about one point on a scale of 0 to ten — 24 hours later.
For those with known strep throat, steroids worked more quickly, bringing pain relief about 45 minutes sooner.
Repeated steroid use can cause harm
The benefits, Rowe said, aren't enough to justify widespread use of steroids for sore throat. It's unlikely that patients would even be able to detect the one-point difference in pain, he said.
None of the studies in this analysis reported any serious problems associated with steroid use. However, repeated steroid use can have serious side effects, such as weaker bones, Rowe added, noting that many people may get several sore throats a year — meaning they could wind up getting a lot of steroids. Short-term effects of steroids include swelling, stomach irritation, and restlessness.
However, it is possible that the drugs would be more worthwhile for patients with very inflamed, painful sore throats due to strep infection, he said.
"You've got some evidence that it works," he said. "Should you be giving it to everyone? I would say no."
"There are other things you can do," Rowe said. "You can take Tylenol, you can gargle, you can take lots of fluids, you can rest."
