Evidence
This page contains a snapshot of featured content which highlights evidence addressing key clinical questions including areas of uncertainty. Please see the main topic reference list for details of all sources underpinning this topic.
BMJ Best Practice evidence tables
Evidence tables provide easily navigated layers of evidence in the context of specific clinical questions, using GRADE and a BMJ Best Practice Effectiveness rating. Follow the links at the bottom of the table, which go to the related evidence score in the main topic text, providing additional context for the clinical question. Find out more about our evidence tables.
This table is a summary of the analysis reported in a systematic review that focuses on the above important clinical question.
Confidence in the evidence is moderate or low to moderate where GRADE has been performed and the intervention may be more effective/beneficial than the comparison for key outcomes.
Population: Adults and children ≥ 5 years old with sore throat
Intervention: Corticosteroids
Comparison: No corticosteroids (standard clinical care or placebo)
| Outcome | Effectiveness (BMJ rating)? | Confidence in evidence (GRADE)? |
|---|---|---|
Complete resolution of pain at 24 hours | Favors intervention | Moderate |
Complete resolution of pain at 48 hours | Favors intervention | High |
Recurrence/relapse of symptoms | No statistically significant difference | Moderate |
Antibiotics prescription | No statistically significant difference | Low |
Mean time to onset of pain relief (hours) | Favors intervention | Moderate |
Mean time to complete resolution of pain (hours) | Favors intervention | Low |
Pain reduction 24 hours | Favors intervention | Moderate |
Duration of bad/nontolerable symptoms | - | None of the studies identified by the review assessed this outcome |
Days missed from work or school (follow up to 14 days) | No statistically significant difference | Moderate |
Serious adverse events (follow up to 10 days) | Unknown ᵃ | Moderate |
Note The systematic review (SR) (view the full source systematic review above) excluded studies where participants were immunocompromised, had a peritonsillar abscess, or were admitted to hospital. It should be noted that the largest randomized controlled trial in the meta-analysis was in adults that were judged to not need immediate antibiotic treatment. However, the SR authors found no subgroup effects including children, adults, and people with confirmed group A beta-hemolytic streptococcus infection. The SR reviewers state that few adverse events were reported in the included studies. Most were disease related complications and occurred with similar frequency in treatment and comparison groups. The SR reviewers also conclude that a single dose of a low-dose corticosteroid can provide pain relief in people with sore throats, without increasing serious adverse events. ᵃ Results reported narratively.
This evidence table is related to the following section/s:
Cochrane Clinical Answers
Cochrane Clinical Answers (CCAs) provide a readable, digestible, clinically focused entry point to rigorous research from Cochrane systematic reviews. They are designed to be actionable and to inform decision making at the point of care and have been added to relevant sections of the main Best Practice text.
- How do corticosteroids compare with placebo for adjunctive treatment of people with sore throat?
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