Caveats: The trials included here are, in aggregate, relatively small, and compared different corticosteroids, given at different doses, using different routes of administration. Most of the trials used a single dose of dexamethasone, and in the trials that compared routes, there was no significant difference in symptoms between oral and intramuscular injection. In addition, seven of eight trials allowed but did not control for other analgesics. Antibiotics were co-administered with and without steroids, and no studies assessed the efficacy of steroids in the absence of antibiotics. As the majority of pharyngitis cases are viral in etiology and do not benefit significantly from antibiotics 5 , studies assessing the efficacy of steroids in the absence of antibiotics would be useful.
Finally, steroids in general are well tolerated, particularly with short term use, but there are known adverse effects such as hyperglycemia and mood changes. 6 While no harms were identified in this analysis, and although they may be rare, the trials included here were underpowered to detect adverse events.
Only two of the included studies focused on pediatric patients, and together yielded mixed results. In addition, there are reported cases in which steroids have masked acute leukemia in pediatric patients presenting with sore throat. 7 Thus, further study in children is warranted.
Antibiotic failure in the treatment of streptococcal tonsillopharyngitis
Group A streptococcal tonsillopharyngitis in children and adolescents: Clinical features and diagnosis
Complications of streptococcal tonsillopharyngitis
Evaluation of acute pharyngitis in adults
Evaluation of sore throat in children
Periodic fever with aphthous stomatitis, pharyngitis, and adenitis (PFAPA syndrome)
Peritonsillar cellulitis and abscess
Sore throat in children and adolescents: Symptomatic treatment
Tonsillectomy and/or adenoidectomy in children: Indications and contraindications
Treatment and prevention of streptococcal tonsillopharyngitis
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Anti-reflux medications may be prescribed for patients with signs of chronic laryngitis and hoarse voice.  If anti-reflux treatment does not result in a decrease of symptoms, other possible causes should be examined.  Over-the-counter medications for neutralizing acids ( antacids ) and acid suppressants ( H-2 blockers ) may be used.  Antacids are often short-acting and may not be sufficient for treatment.  Proton pump inhibitors are an effective type of medication.  These should only be prescribed for a set period of time, after which the symptoms should be reviewed.  Proton pump inhibitors do not work for everyone. A physical reflux barrier (. Gaviscon Liquid) may be more appropriate for some.  Antisecretory medications can have several side-effects.