Dexamethasone for Acute Sore Throat? — Physician’s First Watch
Dexamethasone for Acute Sore Throat?
By Amy Orciari Herman
Dexamethasone may offer some relief for acute sore throat, a JAMA study finds.
Nearly 600 U.K. adults presenting to primary care with acute sore throat assessed not to be in imminent need of antibiotics were randomized to one 10-mg dose of oral dexamethasone or placebo. Clinicians offered, at their discretion, no antibiotic prescription or a delayed prescription (usually with instructions for use if symptoms persisted at 48 hours).
The primary outcome — complete resolution of sore throat at 24 hours — did not differ significantly between the dexamethasone and placebo groups. A secondary outcome — complete resolution at 48 hours — did favor dexamethasone (35% vs. 27%; number needed to treat, 12).
Dr. Thomas Schwenk of NEJM Journal Watch General Medicine commented: "These results need to be assessed in light of the original patient selection — participants were considered to have less severe sore throats not requiring initial antibiotics. Exposing 12 patients to even a modest single corticosteroid dose in order to shorten the course of a mild, self-limited sore throat does not seem prudent."