DB'S MEDICAL RANTS

Internal medicine, American health care, and especially medical education

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Sore throats – steroids and @medpedshosp

I missed this back in December – The rediscovery of pharyngitis in adolescents and Arcanobacterium hemolyticum

Yesterday I was seeing a new admission in the ER and ran into a colleague admitting a sore throat patient.  You can imagine that I rarely miss the opportunity to examine and take a history from sore throat patients.  Yesterday’s patient has a small tonsillar abscess.

Medpedshosp talks about my Annals article and adds a nice description of Arcanebacterium pharyngitis.  He writes well, and the article is well worth reading.

There is a new trend in pharyngitis that has taken hold amongst emergency physicians – the use of steroids to provide symptom relief.  Two recent articles address this issue:

  • Corticosteroids for pain relief in sore throat: systematic review and meta-analysis
  • Steroids as Adjuvant Therapy for Acute Pharyngitis in Ambulatory Patients: A Systematic Review

I was asked to write a comment on the second article – scroll to the end of the article to find the link.  These articles do not include enough patients to really know about complications due to steroids masking worsening symptoms.  Maybe I am a curmudgeon, but I worry about potential downsides for minor upside with steroids.

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