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Sore throat? Steroids are 'not a silver bullet treatment'

Many physicians prescribe steroids to treat a sore throat, but the findings of a new study by researchers at the University of Oxford question the effectiveness of corticosteroids such as Maxidex (dexamethasone) in treating a sore throat. The study published in the Journal of the American Medical Association looked at the effects of a single dose of dexamethasone on adults complaining of a sore throat. Commenting on the study in her blog, Gail Hayward MD, one of the report's authors, said steroid treatment for sore throats is "not the silver bullet we considered it might be". 

While there was little chance of symptom resolution within 24 hours of a dose of steroids, the study found there was a "significant difference" after 48 hours. Following a two-day recovery period, almost a quarter of unposed patients reported feeling better. During the same timeframe, 35 percent of those who received steroidal medication said their symptoms improved. Interpreting the data, Hayward noted a doctor would have to prescribe steroids to 12 patients in order to help one additional patient feel better within 48 hours. 

A number of possible adverse side effects are associated with corticosteroids, including changes in mood, increased appetite, weaker bones and high blood pressure. The evidence of the report along with the side effects of corticosteroids and  "general consensus" that sore throats improve without treatment, suggest steroids should not be routinely used on patients with a sore throat in primary care, Hayward asserted.  

"[Doctors] should continue to fall back on conventional wisdom for sore throat - over-the-counter (OTC) painkillers, drinking plenty of fluids and time," she stated. However, she qualified her conclusions by observing the anti-inflammatory effects of corticosteroids may be useful in managing sore throats, particularly in hospital or when patients struggle with other drugs.  

Her advice was echoed by Robert Centor MD, professor of internal medicine at the University of Alabama at Birmingham, who told HealthDay News the majority of sore throat cases are "relatively simple". The health care expert, who was not involved in the study, suggested patients experiencing a painful sore throat might benefit from painkillers such as Tylenol (acetaminophen), Advil (ibuprofen) or Aleve (naproxen).

He also warned treating sore throats with steroids may mask more serious, underlying conditions, such as a bacterial infection. Patients with a sore throat who also experience a significant fever, sweating, or symptoms lasting more than three to five days should seek medical advice, he added. A sore throat may have a number of possible causes, ranging from environmental irritants to viruses, bacteria and allergens. Children are particularly susceptible to strep throat - a bacterial infection of the throat and tonsils that should be treated with antibiotics. Viral sore throats are often accompanied by cold symptoms, such as a runny nose, cough and sneezing. 

If you are concerned about a sore throat or need advice on over-the-counter or prescription medication, speak to your pharmacist or doctor about treatment options.