A Cochrane review [Abstract] 1 included 7 trials including a total of 362 patients. The diagnosis, steroid regime, outcomes and methodological quality varied between trials. For sore throat the results of two studies suggest a benefit at 12 hours of steroid therapy over placebo; however this benefit was not maintained. One trial suggests a longer benefit when the steroid is combined with an antiviral drug. Steroids may improve resolution of fatigue around four weeks (1 trial); however it is unclear if this is only in combination with an antiviral. Two trials reported severe complications in participants in the steroid group.
Comment: The quality of evidence is downgraded by study quality, (several limitations), by inconsistency (heterogeneity in interventions and outcomes), by indirectness (differences in studied patients), and by imprecise results (limited study size for each comparison).
Clinical comment: Steroids are generally used for severe complications of infectious mononucleosis particularly compromised airways but this is not a subject of this review.
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