Sore Throat Treatments – How Effective are Other Things

Disclaimer, this is a layman’s review of a published review paper.  Use the treatments given here only under the advice of a doctor.  If you have a severe sore throat, or have one for longer than a few days, you should see a doctor.
ResearchBlogging.org

PATIENTS frequently attend general practices in the industrial
western world with the complaint of sore throat. Although
the illness is usually self-limiting, it is such a common reason for
attending the doctor that its treatment is of considerable interest.  Treatment has always been controversial, with most debate concerning whether antibiotics should be used.

So what should we do for a sore throat?  This is just the garden variety complaint here.  I’m not specifically talking about Strep throat or Tonsillitis.  A 7-10 day course of antibiotics reduces the length of time symptoms are present by almost half a day.  That’s it twelve whole hours.

Most doctors in the US, especially in the mid 80s and 90s automatically proscribed an antibiotic anytime someone complained of a sore throat.  This is what may be considered an overuse of antibiotics resulting in antibiotic resistant strains of bacteria appearing.

So, what should doctors do?

Michael Thomas, Chris Del Mar, and Paul Glasziou  at the University of Queensland, Australia undertook a review of research studies to examine treatments. The authors examined 66 papers and then excluded 46 of them for having methodology problems.  They discarded all studies that were not at least single blind, did not have suitable controls, too many dropouts, and several other issues.

The authors found in these studies that basic treatments were very effective in many cases.  IN all the short-term studies (less than 24 hours), aspirin and ibuprofen were the best treatments.  Basic as ibuprofen for children resulted in a 56% decrease in sore throat after two days.

The non-steroidal anti-inflammatory drug (NSAID) ibuprofen
appeared to have immediate efficacy, reducing throat pain in
adults by between 32% and 80% relative to placebo after two to
four hours, and 70% at six hours.  In children it had a lower efficacy (25% after two hours), although after two days there was a 56% reduction in patients still with sore throat.

For the longer term (3 days), again anti-inflammatory pain-relievers (ibuprofen) had fantastic results.

The single most surprising result in my mind was the “greater patient communication” trial, in which doctors spent extra time with patients discussing prognosis, treatments, and a longer time spent.  Along with antibiotics, this ‘greater communication’ resulted in a 40% decrease in the number of patients not better after two days.

The take home message?

If you are a doctor, spend some extra time with your patients.  It actually helps them get better.

Everyone else, take some ibuprofen and avoid a trip to the doctor, the insurance, and pharmacy.

___________________________________________________
Thomas M, Del Mar C, & Glasziou P (2000). How effective are treatments other than antibiotics for acute sore throat? The British journal of general practice : the journal of the Royal College of General Practitioners, 50 (459), 817-20 PMID: 11127175

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