Why do doctors prescribe Prednisone for sore throat?

Prednisone for sore throat
Medically reviewed by Dr. Mehvish Khan

Overview

With the winter holidays and the festival season comes the most prevalent issue among children and adults – sore throat. Most of the causes of sore throat are viral or bacterial and go away in a few days with over-the-counter (OTC) medications like NSAIDs to relieve inflammation and pain. However, in some cases, the sore throat persists for longer developing chronic throat infection. For such infections, doctors often prescribe steroids like prednisone. These steroids function by diminishing inflammation, offering potential benefits in accelerating healing and alleviating pain associated with sore throats.

What does prednisone do for sore throat?

In cases of acute sore throat, evidence suggests that one or two low doses of corticosteroids, such as prednisone, can effectively diminish pain intensity and duration. These medications, taken orally or through injection, target inflammation in the throat lining, relieving symptoms. Doctors may consider prescribing corticosteroids for sore throats marked by significant inflammation, severe or painful symptoms, allergic reactions, infectious mononucleosis (mono), or chronic and recurrent instances linked to underlying conditions like tonsillitis.

If the sore throat infection is acute, it will resolve within 7-10 days and rarely transform into complications. The first line of treatment prescribed by the doctors includes 

  • Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen. 
  • Acetaminophen

However, in severe inflammation, doctors may prescribe steroids only if the patient is not immunocompromised, has had recent surgery, or has a mononucleosis infection.

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How fast does prednisone work for sore throat?

Topical Steroids (Throat sprays or inhalers):

  • Act locally and may provide relief within a few hours to a day.
  • Reduce inflammation, offering rapid alleviation of sore throat symptoms.

Oral Corticosteroids (e.g., Prednisone, Dexamethasone)

  • Typically, it takes longer to show effects compared to topical steroids.
  • Improvement may start within 12–24 hours, with the full effect taking a few days.
  • Speed of relief varies based on the severity of inflammation and the underlying condition.

Some evidence suggests that a single dose of oral corticosteroids increases the likelihood of symptom resolution in acute sore throats within 48 hours.

Is prednisone good for sore throat?

Prednisone and other corticosteroids have shown effectiveness in quickly easing sore throat symptoms, particularly in cases with significant inflammation. A thorough research analysis of nine trials involving 1,319 participants, many already taking antibiotics, revealed that corticosteroids increased the likelihood of complete symptom resolution by 2.4 times within 24 hours. While these steroids did accelerate symptom relief moderately, they did not significantly reduce pain severity or duration, nor did they improve other patient-related outcomes like time off from work or school.

While corticosteroids prove effective for sore throat treatment, their impact on pain severity, duration, and other outcomes is not substantial. Therefore, the decision to use these medications should be collaborative between the physician and the patient.

The need for using prednisone for a sore throat depends upon eight outcomes, including:

  • Complete resolution of pain
  • Time to onset of pain relief
  • Pain severity
  • Need for antibiotics
  • Days missed from school or work
  • Recurrence of symptoms
  • Duration of intolerable symptoms
  • Adverse effects

However, corticosteroids are unlikely to reduce symptom recurrence, and days missed from school or work (moderate-quality evidence). The evidence is low-quality regarding their impact on antibiotic use or the average time for complete pain resolution.

Having a bad sore throat along with a sinus infection Prednisone with antibiotics can provide effective results.

Why do doctors prescribe prednisone with antibiotics?

In illness, doctors may opt for a dual approach, prescribing oral steroids and antibiotics to expedite healing. Prednisone, a steroid, plays a key role in reducing swelling and inflammation associated with the infection, thereby accelerating overall recovery. This combination is particularly advantageous in conditions such as sinus infections, where the reduction of swelling can enhance the effectiveness of the treatment.

While antibiotics can provide modest benefits in reducing symptoms and fever when the infection is bacterial, their use raises concerns about contributing to antibiotic resistance. Although most sore throats have a viral origin, and the risk of secondary complications is low, clinicians often prescribe antibiotics. This practice may be influenced by the perception that patients seeking care expect a course of antibiotics, even though their primary concern may be pain relief.

Typically, corticosteroids are prescribed at a dose of 10 mg of dexamethasone for adults (0.6 mg per kg for children, with a maximum dose of 10 mg), either as a pill or through intramuscular injection. Equivalent doses of other corticosteroids may also be considered. However, caution is advised when administering larger doses to individuals with recurrent sore throat episodes, as the potential risks may outweigh the benefits. To address this concern, healthcare providers are encouraged to administer the medication in the office whenever possible or limit the prescription to a single dose per visit.

Emphasizing the importance of shared decision-making is crucial. While a single dose of corticosteroids may seem innocuous, the cumulative use requires consultation with a doctor. You should discuss the potential benefits and your medical history with a doctor before taking different steroids and prednisone for infections.

What are the side effects of taking prednisone for a sore throat?

The short-term side effects of corticosteroids may include:

  • Insomnia
  • Fluid retention
  • Mood changes
  • Digestive issues
  • Increased appetite
  • Elevated blood pressure

Long-term effects:

  • Cataracts
  • Glaucoma
  • Skin issues
  • Osteoporosis
  • Adrenal suppression
  • Weakening of the immune system

Awareness of these potential side effects is crucial, and consultation with healthcare professionals is recommended to assess the risks and benefits of using prednisone for sore throat treatment.

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Consult a doctor

Consult your doctor immediately if you have a fever, chills, sore throat, or any other sign of an infection. Check with your doctor immediately if blurred vision, difficulty in reading, eye pain, or any other change in vision occurs during or after treatment.

Even if you have side effects from the medication, don’t stop right away or cut back the dose on your own if you’ve been on it for more than a few weeks. You could go into steroid withdrawal, which can have severe symptoms. Your doctor will gradually lower your dose.

Other FAQs about Prednisone for sore throat

Can prednisolone 20mg help sore throat?

Yes, prednisolone, a corticosteroid, can effectively reduce pain, inflammation, and symptoms associated with strep throat. It also treats arthritis, blood disorders, skin diseases, and allergies. 

What is the best medicine for a sore throat?

Nonsteroidal anti-inflammatory drugs (NSAIDs) are considered effective in relieving pain and swelling by reducing the inflammation causing a sore throat. Common NSAIDs include Ibuprofen (Advil® or Motrin®) and Naproxen (Aleve®).

How long is too long for a sore throat?

Sore throats are frequently encountered, often due to viral infections. However, persistent or severe pain may signal a more serious issue. If your throat discomfort persists beyond three weeks or if you have concerns, it is advisable to consult with your doctor.

Your Doctors Online uses high-quality and trustworthy sources to ensure content accuracy and reliability. We rely on peer-reviewed studies, academic research institutions and medical associations to provide up-to-date and evidence-based information to the users.

  • Bergeson K, Rogers N, Prasad S. PURLs: corticosteroids for a sore throat? J Fam Pract. 2013 Jul;62(7):372-4. PMID: 23957031; PMCID: PMC3701759.
  • de Cassan S, Thompson MJ, Perera R, Glasziou PP, Del Mar CB, Heneghan CJ, Hayward G. Corticosteroids as standalone or add-on treatment for sore throat. Cochrane Database Syst Rev. 2020 May 1;5(5):CD008268. doi: 10.1002/14651858.CD008268.pub3. PMID: 32356360; PMCID: PMC7193118.
  • Sadeghirad BSiemieniuk R A CBrignardello-Petersen RPapola DLytvyn LVandvik P O et al. Corticosteroids for treatment of sore throat: systematic review and meta-analysis of randomised trials doi:10.1136/bmj.j3887

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