Antibióticos para tratamento da dor de garganta em crianças e adultos

Antibiotics for treatment of sore throat in children and adults

Abstract

Background

Sore throat is a common reason for people to present for medical care and to be prescribed antibiotics. Overuse of antibiotics in primary

medicine is a concern, hence it is important to establish their e9icacy in treating sore throat and preventing secondary complications.

Objectives

To assess the e9ects of antibiotics for reducing symptoms of sore throat for child and adult patients.

Search methods

We searched CENTRAL 2021, Issue 2, MEDLINE (January 1966 to April week 1, 2021), Embase (January 1990 to April 2021), and two trial

registries (searched 6 April 2021).

Selection criteria

Randomised controlled trials (RCTs) or quasi-RCTs of antibiotics versus control assessing typical sore throat symptoms or complications

amongst children and adults seeking medical care for sore throat symptoms.

Data collection and analysis

We used standard methodological procedures as recommended by Cochrane. Two review authors independently screened studies for

inclusion and extracted data, resolving any di9erences in opinion by discussion. We contacted the trial authors from three studies for

additional information. We used GRADE to assess the certainty of the evidence for the e9icacy of antibiotics on our primary outcomes (sore

throat at day three and one week) and secondary outcomes (fever and headache symptoms and incidence of acute rheumatic fever, acute

glomerulonephritis, acute otitis media, acute sinusitis, and quinsy).

Main results

We included 29 trials with 15,337 cases of sore throat. The majority of included studies were conducted in the 1950s, during which time

the rates of serious complications (especially acute rheumatic fever) were much higher than today. Although clinical antibiotic trials for

sore throat and respiratory symptoms are still being conducted, it is unusual for them to include placebo or 'no treatment' control arms,

which is a requirement for inclusion in the review.

The age of participants ranged from younger than one year to older than 50 years, but most participants across all studies were adults.

Although all studies recruited patients presenting with symptoms of sore throat, few of them distinguished between bacterial and viral

aetiology. Bias may have been introduced through non-clarity in treatment allocation procedures and lack of blinding in some studies.

Harms from antibiotics were poorly or inconsistently reported, and were thus not quantified for this review.