Dexamethasone for Acute Sore Throat?

By Amy Orciari Herman

Edited by David G. Fairchild, MD, MPH, and Lorenzo Di Francesco, MD, FACP, FHM

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."