Antibiotics for sore throat.

[acute rheumatic fever]

Sore throat is a common reason for people to present for medical care . Although it remits spontaneously , primary care doctors commonly prescribe antibiotics for it .To assess the benefits of antibiotics for sore throat for patients in primary care settings .We searched CENTRAL 2013 , Issue 6 , MEDLINE (January 1966 to July week 1 , 2013 ) and EMBASE (January 1990 to July 2013 ).Randomised controlled trials (RCTs ) or quasi-RCTs of antibiotics versus control assessing typical sore throat symptoms or complications .Two review authors independently screened studies for inclusion and extracted data . We resolved differences in opinion by discussion . We contacted trial authors from three studies for additional information .We included 27 trials with 12 ,835 cases of sore throat . We did not identify any new trials in this 2013 update . 1 . Symptoms Throat soreness and fever were reduced by about half by using antibiotics . The greatest difference was seen at day three . The number needed to treat to benefit (NNTB ) to prevent one sore throat at day three was less than six ; at week one it was 21 . 2 . Non-suppurative complications The trend was antibiotics protecting against acute glomerulonephritis but there were too few cases to be sure . Several studies found antibiotics reduced acute rheumatic fever by more than two -thirds within one month (risk ratio (RR ) 0 .27 ; 95 % confidence interval (CI ) 0 .12 to 0 .60 ). 3 . Suppurative complications Antibiotics reduced the incidence of acute otitis media within 14 days (RR 0 .30 ; 95 % CI 0 .15 to 0 .58 ); acute sinusitis within 14 days (RR 0 .48 ; 95 % CI 0 .08 to 2 .76 ); and quinsy within two months (RR 0 .15 ; 95 % CI 0 .05 to 0 .47 ) compared to those taking placebo . 4 . Subgroup analyses of symptom reduction Antibiotics were more effective against symptoms at day three (RR 0 .58 ; 95 % CI 0 .48 to 0 .71 ) if throat swabs were positive for Streptococcus , compared to RR 0 .78 ; 95 % CI 0 .63 to 0 .97 if negative . Similarly at week one the RR was 0 .29 (95 % CI 0 .12 to 0 .70 ) for positive and 0 .73 (95 % CI 0 .50 to 1 .07 ) for negative Streptococcus swabs .Antibiotics confer relative benefits in the treatment of sore throat . However , the absolute benefits are modest . Protecting sore throat sufferers against suppurative and non-suppurative complications in high -income countries requires treating many with antibiotics for one to benefit . This NNTB may be lower in low -income countries . Antibiotics shorten the duration of symptoms by about 16 hours overall .

Diseases
Validation

Diseases presenting "acute glomerulonephritis" symptom

acute rheumatic fever

familial mediterranean fever

scrub typhus

typhoid

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