From the Research
Prednisone 40mg for 3 days is not the first-line treatment for a 24-year-old female with tonsillar hypertrophy, negative streptococcal test, and no improvement with NSAIDs. Instead, consider the following approach:
- Continue NSAIDs for pain relief, ensuring proper dosing and frequency.
- Use saltwater gargles or throat lozenges for symptomatic relief.
- If symptoms persist or worsen after 5-7 days, consult a healthcare provider for further evaluation. Prednisone, while effective for reducing inflammation, is typically reserved for severe cases or when other treatments have failed, as seen in studies such as 1 and 2. It can have side effects and may mask underlying issues. The cause of the enlarged tonsils should be determined before starting steroids. Viral infections, which are common causes of tonsillitis, generally resolve on their own with supportive care. If bacterial infection is suspected despite the negative strep test, a broader spectrum antibiotic might be considered after clinical assessment. The most recent and highest quality study, 2, suggests that a short course of prednisone can be effective in reducing inflammation, but it is essential to weigh the benefits and risks in the context of tonsillar hypertrophy. In this case, given the lack of severe symptoms or life-threatening conditions, it is reasonable to prioritize supportive care and monitor the patient's condition before considering prednisone or other steroid treatments.