The effectiveness of steroids in the treatment of deep neck abscess: a systematic review and meta-analysis

The aim of this systematic review is to evaluate the effectiveness of steroids in combination with intravenous antibiotics in the management of neck abscesses.We performed a systematic literature review from inception to September 2024 in the following databases: PubMed/ MEDLINE, Scopus, CENTRAL via Cochrane and the National Institute of Health Clinical Trials Register. We included studies with adults and pediatric patients with confirmed deep neck abscesses. The treatment was single dose or systematic use of corticosteroids in combination with antibiotics versus control. Our primary outcome was surgical drainage and as secondary outcomes we observed duration of hospitalization and symptom relief, such as trismus, pain relief and resolution of fever. Seven studies were included in the systematic review (2.708 patients). The use of corticosteroids has a beneficial role in the reduction of surgical drainage compared to control. The overall odds ratio was 3.26 (95% CI: 2.17-4.88), reinforcing that patients treating with steroids are over three times more likely to avoid surgery. Regarding hospitalization, corticosteroids led to an average reduction up to 1.47 days compared to control. The included studies demonstrated significant improvement in pain relief, trismus and fever in corticosteroid group compared to control group. This systematic review and meta-analysis reinforces the role of corticosteroids as a beneficial adjunctive therapy in the treatment of deep neck abscesses.