Commentary

This systematic review by Thomas et al consolidates the research comparing pharmacological, non-antibiotic interventions with placebo for the treatment of acute sore throat. A previous meta-analysis by the same authors found that antibiotics offer a small reduction in duration and complications related to sore throat, compared with placebo or no treatment.¹ Many of the alternative treatments to antibiotics had larger effect sizes than antibiotics; the authors acknowledge, however, an absence of data comparing these alternatives directly with antibiotics. In addition, the trials included in this review did not seem to address potential side effects, drug interactions, allergies, contraindications, and other complications of the non-antibiotic treatments.

Strengths of this review include the focus on randomised controlled trials, the exclusion of studies with excessive dropouts and unclear randomisation and blinding, and the inclusion of trials written in any language. Unpublished studies were not included which, as the authors note, can lead to publication bias and exaggerated treatment effects.

The finding that non-antibiotic interventions reduce sore throat symptoms better than placebo has implications for client education done by nurses and physicians in the primary care setting; that is, practitioners can promote client empowerment by encouraging self care for sore throats.

Future research may focus on obtaining information that compares the effects of various dosing amounts, timing, and duration of the pharmacological methods described.