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 Antibiotics don’t help viral infections, which cause the majority of
sore throats. Doctors still regularly prescribe antibiotics for sore
throats, however, and excessive use has given rise to so-called
super bugs that can cause severe infections and don’t respond to
available treatments.
Because bacterial infections can cause some sore throats - such as
“strep throat,” caused by Streptococcal bacteria - researchers
wanted to see if one of two plausible options might help: xylitol, a
birch sugar that has been linked to reduced bacterial growth and
inflammation in the mouth, or probiotics, harmless bacteria that can
block the spread of some harmful bacterial infections.
The researchers randomly assigned nearly 1,000 people with sore
throats to one of four regimens: chewing gum containing xylitol;
probiotic capsules; both treatments combined; or a control group
that only got a different gum without xylitol.
They found that xylitol and probiotics didn’t work any better than
the gum without any remedy at all, according to the report in the
Canadian Medical Association Journal.
“We were hoping that one or the other would prove beneficial in sore
throat but unfortunately not,” said senior study author Michael
Moore of the University of Southampton in the UK.
“It was not clear before the trial whether they would be helpful or
not, but it is a priority to find alternative approaches to
treatment that don’t involve antibiotics so it was worth testing out
these two potential treatments,” Moore said by email.
The study included 934 people, with complete data on the effect of
the remedies available for 689 individuals.
All of the study participants came to the doctor complaining of a
sore throat. At the initial exams, about two-thirds had inflammation
in their throat and more than half had a cough.
Most had also experienced at least one previous sore throat in the
previous three months, and more than 30 percent had at least three
sore throat episodes.
They were randomly assigned to one of the four treatment groups, and
then asked to record a diary of symptoms and the number of probiotic
capsules or sticks of gum they had each day depending on what group
they were in.
If gum was part of their regimen, participants were asked to chew
five pieces daily. If their treatment included probiotics, they were
asked to take one capsule daily with milk.
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Participants were considered compliant with their assigned treatment
if they followed these directions at least 75 percent of the time.
After three months, participants didn’t report any meaningful
difference in the severity of sore throat symptoms or difficulty
swallowing based on what group they were in.
One limitation of the study is that many participants dropped out
before three months or didn’t provide complete data, the authors
note. Another drawback is that the study wasn’t long enough to
assess whether the tested remedies might help in the long run if
people got recurring sore throats.
Still, the findings suggest there is no reason for doctors to
prescribe probiotics or xylitol for sore throats, the researchers
conclude.
For patients with strep throat, penicillin works and antibiotics are
an effective and appropriate treatment, noted Dr. Jeffrey Linder, a
researcher at Northwestern University Feinberg School of Medicine in
Chicago.
“Most sore throats are not strep and should be treated
symptomatically,” Linder, who wasn’t involved in the study, said by
email.
This means getting plenty of rest, drinking plenty of fluids, and
taking over the counter medications for inflammation and pain,
Linder advised.
“You should only take antibiotics if you have a positive test for
strep throat,” Linder added.
SOURCE: http://bit.ly/2AUZj2d Canadian Medical Association Journal,
online December 18, 2017.
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