Dexamethasone May Reduce Sore Throat Symptoms in Adults at 48 Hours
Am Fam Physician. 2017 Aug 15;96(4):260-261.
Are oral steroids effective in the treatment of acute sore throat in adults?
A single dose of oral dexamethasone is no more effective than placebo in resolving acute sore throat symptoms at 24 hours in adults who do not receive immediate antibiotic therapy. However, among a multitude of exploratory secondary outcomes, the authors found that, compared with placebo, dexamethasone increased the proportion of patients with symptom resolution at 48 hours (number needed to treat [NNT] = 12; 95% confidence interval [CI], 7 to 146). (Level of Evidence = 1b)
These investigators identified adults, 18 years or older, who presented to primary care offices in England with acute symptoms of sore throat and odynophagia for which the treating clinician did not prescribe immediate antibiotic therapy. Exclusion criteria included the recent use of inhaled or oral steroids, recent adenotonsillectomy, recent use of antibiotics, or a clear alternative diagnosis such as pneumonia. Eligible participants randomly received (concealed allocation assignment) a single dose of dexamethasone (10 mg) or matching placebo; 11 patients were found ineligible and excluded after participation. Treating clinicians could decide to offer no antibiotics (n = 349) or a delayed antibiotic (n = 227). Patients unaware of group assignment self-assessed outcomes including the primary outcome of complete resolution of sore throat symptoms at 24 hours. Secondary exploratory outcomes included complete resolution of sore throat at 48 hours, duration of moderately bad symptoms, time to onset of pain relief and time to complete resolution of symptoms, consumption of delayed antibiotic prescription, time missed from work or education, attendance at or telephone contact with any heath care facility because of the sore throat, and use of over-the-counter medications and/or other prescription medications in the first seven days. Complete follow-up occurred for 94% of participants at one month.
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