. 2017 Sep 20:358:j4090.

doi: 10.1136/bmj.j4090.

Corticosteroids for sore throat: a clinical practice guideline

Bert Aertgeerts^{1

2}, Thomas Agoritsas^{3

4}, Reed A C Siemieniuk^{3

5}, Jako Burgers^{6

7}, Geertruida E Bekkering^{8

2}, Arnaud Merglen⁹, Mieke van Driel¹⁰, Mieke Vermandere⁸, Dominique Bullens^{11

12}, Patrick Mbah Okwen¹³, Ricardo Niño¹⁴, Ann van den Bruel^{15

16}, Lyubov Lytvyn¹⁷, Carla Berg-Nelson^{18

19}, Shunjie Chua²⁰, Jack Leahy²¹, Jennifer Raven²², Michael Weinberg²³, Behnam Sadeghirad^{3

24}, Per O Vandvik^{16

25}, Romina Brignardello-Petersen^{2

26}

Affiliations

¹ Academic Centre for General Practice, Department of Public Health and Primary Care, KU Leuven, Belgium bert.aertgeerts@kuleuven.be.
² CEBAM, Belgian Centre for Evidence-Based Medicine, Cochrane Belgium, Leuven, Belgium.
³ Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada L8S 4L8.
⁴ Division General Internal Medicine & Division of Clinical Epidemiology, University Hospitals of Geneva, CH-1211, Geneva, Switzerland.
⁵ Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
⁶ Dutch College of General Practitioners, Utrecht, The Netherlands.
⁷ School CAPHRI, Department Family Medicine, Maastricht, The Netherlands.
⁸ Academic Centre for General Practice, Department of Public Health and Primary Care, KU Leuven, Belgium.
⁹ Division of General Pediatrics, University Hospitals of Geneva & Faculty of Medicine, University of Geneva, Geneva, Switzerland.
¹⁰ Primary Care Clinical Unit, Faculty of Medicine, University of Queensland, Brisbane, Australia.
¹¹ Pediatric Immunology, Department of microbiology and immunology, KU Leuven, Belgium.
¹² Pediatric allergy, Clinical division of pediatrics UZ Leuven, Leuven, Belgium.
¹³ Bali District Hospital, Bali and Centre for Development of Best practices in Health Yaounde, Cameroon.
¹⁴ Otorhinolaryngology-Head and Neck Surgery, Clinica del Country, Bogota, Colombia.
¹⁵ NIHR Oxford Diagnostic Evidence Cooperative, Oxford, UK.
¹⁶ Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
¹⁷ Oslo University Hospital, Forskningsveien 2b, Blindern 0317 Oslo, Norway.
¹⁸ The Society for Participatory Medicine, Newburyport, MA 01950-1183, USA.
¹⁹ Arizona Senior Academy, Tucson, AZ 85747, USA.
²⁰ MOH Holdings, 1 Maritime Square, Singapore, Singapore 099253.
²¹ Cochrane UK, London, UK.
²² Cochrane Consumers Group, Halifax, Canada.
²³ Washington DC, USA.
²⁴ HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
²⁵ Department of Medicine, Innlandet Hospital Trust - division Gjøvik, Norway.
²⁶ Faculty of Dentistry, Universidad de Chile, Santiago, Chile.

PMID: 28931507
PMCID: PMC6284245
DOI: 10.1136/bmj.j4090

Corticosteroids for sore throat: a clinical practice guideline

Bert Aertgeerts et al. BMJ. 2017.

. 2017 Sep 20:358:j4090.

doi: 10.1136/bmj.j4090.

Authors

Affiliations

¹ Academic Centre for General Practice, Department of Public Health and Primary Care, KU Leuven, Belgium bert.aertgeerts@kuleuven.be.
² CEBAM, Belgian Centre for Evidence-Based Medicine, Cochrane Belgium, Leuven, Belgium.
³ Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada L8S 4L8.
⁴ Division General Internal Medicine & Division of Clinical Epidemiology, University Hospitals of Geneva, CH-1211, Geneva, Switzerland.
⁵ Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
⁶ Dutch College of General Practitioners, Utrecht, The Netherlands.
⁷ School CAPHRI, Department Family Medicine, Maastricht, The Netherlands.
⁸ Academic Centre for General Practice, Department of Public Health and Primary Care, KU Leuven, Belgium.
⁹ Division of General Pediatrics, University Hospitals of Geneva & Faculty of Medicine, University of Geneva, Geneva, Switzerland.
¹⁰ Primary Care Clinical Unit, Faculty of Medicine, University of Queensland, Brisbane, Australia.
¹¹ Pediatric Immunology, Department of microbiology and immunology, KU Leuven, Belgium.
¹² Pediatric allergy, Clinical division of pediatrics UZ Leuven, Leuven, Belgium.
¹³ Bali District Hospital, Bali and Centre for Development of Best practices in Health Yaounde, Cameroon.
¹⁴ Otorhinolaryngology-Head and Neck Surgery, Clinica del Country, Bogota, Colombia.
¹⁵ NIHR Oxford Diagnostic Evidence Cooperative, Oxford, UK.
¹⁶ Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
¹⁷ Oslo University Hospital, Forskningsveien 2b, Blindern 0317 Oslo, Norway.
¹⁸ The Society for Participatory Medicine, Newburyport, MA 01950-1183, USA.
¹⁹ Arizona Senior Academy, Tucson, AZ 85747, USA.
²⁰ MOH Holdings, 1 Maritime Square, Singapore, Singapore 099253.
²¹ Cochrane UK, London, UK.
²² Cochrane Consumers Group, Halifax, Canada.
²³ Washington DC, USA.
²⁴ HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
²⁵ Department of Medicine, Innlandet Hospital Trust - division Gjøvik, Norway.
²⁶ Faculty of Dentistry, Universidad de Chile, Santiago, Chile.

PMID: 28931507
PMCID: PMC6284245
DOI: 10.1136/bmj.j4090

Erratum in

Corticosteroids for sore throat: a clinical practice guideline.
[No authors listed] [No authors listed] BMJ. 2017 Dec 5;359:j5654. doi: 10.1136/bmj.j5654. BMJ. 2017. PMID: 29208608 Free PMC article. No abstract available.

Abstract

What is the role of a single dose of oral corticosteroids for those with acute sore throat? Using the GRADE framework according to the BMJ Rapid Recommendation process, an expert panel make a weak recommendation in favour of corticosteroid use. The panel produced these recommendations based on a linked systematic review triggered by a large randomised trial published in April 2017. This trial reported that corticosteroids increased the proportion of patients with complete resolution of pain at 48 hours. Box 1 shows all of the articles and evidence linked in this Rapid Recommendation package. The infographic provides the recommendation together with an overview of the absolute benefits and harms of corticosteroids in the standard GRADE format. Table 2 below shows any evidence that has emerged since the publication of this article. Clinicians and their patients can find consultation decision aids to facilitate shared decision making in MAGICapp (www.magicapp.org/goto/guideline/JjXYAL/section/j79pvn).

PubMed Disclaimer

Conflict of interest statement

Competing interests: All authors have completed the BMJ Rapid Recommendations interests disclosure form and a detailed, contextualised description of all disclosures is reported in appendix 2 on bmj.com. As with all BMJ Rapid Recommendations, the executive team and The BMJ judged that no panel member had any financial conflict of interest. Professional and academic interests are minimised as much as possible, while maintaining necessary expertise on the panel to make fully informed decisions.

Figures

None — **Fig 1** Characteristics of patients and trials included in systematic review of effects of corticosteroids on acute sore throat

See this image and copyright information in PMC

References

1. Evans CE, McFarlane AH, Norman GR, Neale KA, Streiner DL. Sore throats in adults: who sees a doctor?Can Fam Physician 1982;28:453-8.pmid:21286075. - PMC - PubMed
1. van Driel ML, De Sutter A, Deveugele M, et al. Are sore throat patients who hope for antibiotics actually asking for pain relief?Ann Fam Med 2006;4:494-9. 10.1370/afm.609 pmid:17148626. - DOI - PMC - PubMed
1. NIVEL Primary care database: Netherlands Institute for Health Services Research; 2012. www.nivel.nl/en/dossier/nivel-primary-care-database.
1. Truyers C, Goderis G, Dewitte H, Akker Mv, Buntinx F. The Intego database: background, methods and basic results of a Flemish general practice-based continuous morbidity registration project. BMC Med Inform Decis Mak 2014;14:48 10.1186/1472-6947-14-48 pmid:24906941. - DOI - PMC - PubMed
1. Barnett ML, Linder JA. Antibiotic prescribing to adults with sore throat in the United States, 1997-2010. JAMA Intern Med 2014;174:138-40. 10.1001/jamainternmed.2013.11673. pmid:24091806. - DOI - PMC - PubMed

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Corticosteroids for sore throat: a clinical practice guideline

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Corticosteroids for sore throat: a clinical practice guideline

Authors

Affiliations

Erratum in

Abstract

Conflict of interest statement

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