Effectiveness of corticosteroid treatment in acute pharyngitis: a systematic review of the literature

摘要: Objectives:  The objective was to examine the effectiveness of corticosteroid treatment for relief pain associated with acute pharyngitis potentially caused by group A beta-hemolytic Streptococcus (GABHS). Methods:  This a systematic review literature. Data sources used were electronic databases (Cochrane Library, MEDLINE, EMBASE, Biosis Previews, Scopus, and Web Science), controlled trial registration websites, conference proceedings, study references, experts in field, correspondence authors. Selection criteria consisted randomized trials (RCTs) which corticosteroids, alone or combination antibiotics, compared placebo any other standard therapy adult patients, pediatric both. Two reviewers independently assessed relevance, inclusion, quality. Weighted mean differences (WMDs) calculated are reported corresponding 95% confidence intervals (CIs). Results:  From 272 relevant citations, 10 studies met inclusion criteria. When placebo, corticosteroids reduced time clinically meaningful (WMD = −4.54 hours; CI = −7.19 −1.89); however, they provided only small reduction scores at 24 hours (WMD = −0.90 on 0−10 visual analog scale; CI = −1.5 −0.3). Heterogeneity among pooled identified both outcomes (I2 = 81 74%, respectively); GABHS-positive subgroup receiving did have significant 5.22 hours (95% CI = −7.02 −3.42; I2 = 0%). Short-term side effect profiles between groups similar. Conclusions:  Corticosteroid administration relatively (4.5-hour reduction) (0.9-point reduction), heterogeneity results. Decision-making should be individualized determine risks benefits; not as routine pharyngitis. ACADEMIC EMERGENCY MEDICINE 2010; 17:476–483 © 2010 Society Academic Emergency Medicine