The article by Hayward and colleagues addresses one of the most common symptom presentations, and controversies, in medicine: a patient with a sore throat. In recent years, the reduction of unnecessary antibiotic use in all respiratory infections has become especially important to limit antibiotic resistance. The authors point out that “the pressure for clinicians to reduce antibiotic prescriptions for sore throats leaves a vacuum”. As a result, the use of corticosteroids as an alternative treatment is appealing.

The methods used in this meta-analysis were rigorous. An extensive search for high-quality studies was undertaken. Decisions about which studies were included and excluded were transparent and clear. High-quality statistical methods for combing data were applied, and the results are presented clearly. However, as in many meta-analyses, the authors are ultimately limited by the available studies and the outcomes these studies report. In …