Could a Single Dose of Oral Corticosteroid Treat Acute Sore Throat?

A single dose of dexamethasone did not increase the likelihood of resolved acute sore throat symptoms at 24 hours, but did increase the likelihood of resolved symptoms after 48 hours compared with placebo, according to the results of a new study.

The placebo-controlled randomized trial included 565 adult patients with acute sore throat that did not require immediate antibiotic therapy from 42 family practices in the United Kingdom. An oral dose of 10 mg of dexamethasone was given to 288 participants, and placebo was given to 277 participants.
_________________________________________________________________________________________________________________________________________________________________________
RELATED CONTENT
Leukemic Tonsillitis Presenting as Sore Throat
A Girl With a Sore Throat, Fever, and Strawberry Tongue
_________________________________________________________________________________________________________________________________________________________________________

The primary outcome was the complete resolution of symptoms after 24 hours. Secondary outcomes measured in the study included the complete resolution of symptoms after 48 hours, duration of moderately bad symptoms, days missed from work or school, and consumption of delayed antibiotics or other medications.

After 24 hours, 65 participants (22.6%) assigned to receive dexamethasone and 49 participants (17.7%) assigned to received placebo achieved complete resolution of symptoms.

At 48 hours, a total of 102 participants (35.4%) who received dexamethasone had complete resolution of symptoms compared with 75 participants (27.1%) in the placebo group.

The researchers did not observe any significant differences in comparisons with other secondary outcomes.

“For patients seeking primary care for a sore throat that is not judged to require immediate antibiotics, no significant benefit of dexamethasone on complete resolution of symptoms at 24 hours was found. However, at 48 hours dexamethasone resulted in a significant increase in the proportion of participants reporting complete resolution, requiring an average of 12 patients to be treated for 1 additional patient to experience symptom resolution,” the researchers concluded.

—Melissa Weiss

Reference:

Hayward GN, Hay AD, Moore MV, et al. Effect of oral dexamethasone without immediate antibiotics vs placebo on acute sore throat in adults: a randomized clinical trial [published online April 18, 2017]. JAMA. doi:10.1001/jama.2017.3417.