The use of a single oral dose of dexamethasone in adult patients with acute sore throat did not increase the chances of symptom resolution within 24 hours, however symptoms were more likely to resolve at 48 hours in these patients. These are the findings of a new study published in JAMA.

A total of 576 adults who presented at 42 primary care family practices in England with acute sore throat that did not require immediate antibiotic treatment were enrolled in the study. They were randomized to receive either 10mg of dexamethasone (n=293) or identical placebo (n=283). 

The primary outcome was patient reported complete resolution of sore throat at 24 hours with a secondary outcome of complete resolution of sore throat at 48 hours. Other secondary outcomes included missed work/school days and adverse events. 

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The researchers found no difference in symptom resolution at 24 hours, with 65 (22.6%) of the 288 patients who received dexamethasone reporting complete resolution of symptoms compared to 49 (17.7%) of 277 who received placebo; relative risk (RR) of 1.28 (95% CI, 0.92 to 1.78, = 0.14); risk difference of 4.7% (95% CI, −1.8% to 11.2%). This outcome did not differ among the participants who were offered a delayed antibiotic prescription versus those who were not.

However, at 48 hours, more patients receiving dexamethasone than placebo (35.4% vs 27.1%) had complete symptom resolution, which was also observed in patients not offered delayed antibiotics.

No significant differences were noted in any of the other secondary outcomes such as missed work and school days and adverse events.

“Corticosteroids may have clinical benefit in addition to antibiotics for severe sore throat, for example, to reduce hospital admissions of those patients who are unable to swallow fluids or medications. There have been no trials of corticosteroid use involving these patient groups.”

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