別污名化steroid..使用prednisolone可以使嚴重URI，特別是有細菌感染的exudate，早6小時止痛-> 60mg prednisolone ..
Systemic Steroids for Pharyngitis Pain?
A meta-analysis suggests modest benefit.
A 2009 meta-analysis suggested that administration of corticosteroids for patients with acute pharyngitis increases the likelihood of pain resolution at 24 and 48 hours and hastens pain relief by approximately 6 hours, particularly in patients with positive bacteriologic tests or presence of exudate (JW Emerg Med Aug 28 2009). In the current study, researchers conducted a meta-analysis of the eight trials included in the prior analysis plus two additional randomized, controlled trials in which corticosteroids (alone or in combination with antibiotics) were compared to placebo or standard therapy in adults, children, or both.
The 10 studies involved 1096 patients. Seven studies used dexamethasone (0.6 mg/kg to a maximum of 10 mg orally), and three used prednisone (60 mg orally), betamethasone (2 mL intramuscularly), or cortisone (500 or 600 mg intramuscularly). In pooled analyses, corticosteroids decreased the time to clinically significant pain relief by 4.5 hours. However, at 24 hours, the mean reduction in pain scores associated with corticosteroids (0.9 points on a 10-point visual analog scale) was not clinically significant. No serious adverse events were attributable to corticosteroids.
Comment: This study and the prior analysis show a modest improvement in time to pain relief when steroids are added to usual treatment for acute pharyngitis. Although the data are not compelling, a single oral dose of corticosteroids (e.g., 60 mg of prednisone) is a reasonable option for adults with acute severe pharyngitis with bacterial etiology or exudate.
— Diane M. Birnbaumer, MD, FACEP
Published in Journal Watch Emergency Medicine June 4, 2010
Citation(s):
Wing A et al. Effectiveness of corticosteroid treatment in acute pharyngitis: A systematic review of the literature. Acad Emerg Med 2010 May; 17:476.
A meta-analysis suggests modest benefit.
A 2009 meta-analysis suggested that administration of corticosteroids for patients with acute pharyngitis increases the likelihood of pain resolution at 24 and 48 hours and hastens pain relief by approximately 6 hours, particularly in patients with positive bacteriologic tests or presence of exudate (JW Emerg Med Aug 28 2009). In the current study, researchers conducted a meta-analysis of the eight trials included in the prior analysis plus two additional randomized, controlled trials in which corticosteroids (alone or in combination with antibiotics) were compared to placebo or standard therapy in adults, children, or both.
The 10 studies involved 1096 patients. Seven studies used dexamethasone (0.6 mg/kg to a maximum of 10 mg orally), and three used prednisone (60 mg orally), betamethasone (2 mL intramuscularly), or cortisone (500 or 600 mg intramuscularly). In pooled analyses, corticosteroids decreased the time to clinically significant pain relief by 4.5 hours. However, at 24 hours, the mean reduction in pain scores associated with corticosteroids (0.9 points on a 10-point visual analog scale) was not clinically significant. No serious adverse events were attributable to corticosteroids.
Comment: This study and the prior analysis show a modest improvement in time to pain relief when steroids are added to usual treatment for acute pharyngitis. Although the data are not compelling, a single oral dose of corticosteroids (e.g., 60 mg of prednisone) is a reasonable option for adults with acute severe pharyngitis with bacterial etiology or exudate.
— Diane M. Birnbaumer, MD, FACEP
Published in Journal Watch Emergency Medicine June 4, 2010
Citation(s):
Wing A et al. Effectiveness of corticosteroid treatment in acute pharyngitis: A systematic review of the literature. Acad Emerg Med 2010 May; 17:476.
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