British researchers have cast doubt on the role of oral dexamethasone in the treatment of adults with a sore throat.
Dr Gail Hayward of Oxford University, UK, and colleagues set out to assess the clinical effectiveness of oral corticosteroids for acute sore throat, when antibiotics are not used.
They gave either a single oral dose of dexamethasone or placebo to 565 adults at 42 family practices in South and West England.
After 24 hours, "participants receiving dexamethasone were not more likely than those receiving placebo to have complete symptom resolution," say the authors in JAMA yesterday (18 April).
After 48 hours, significantly more (35%) in the dexamethasone group than the placebo group (27%) had complete resolution of symptoms. But this required an average of 12 patients to be treated for one additional patient to become symptom-free.
The authors write: "To our knowledge, this is the first trial to evaluate the benefits of oral corticosteroids for acute sore throat in a primary care setting."
They point out that "uncertainty remains about the role of oral corticosteroids for patients presenting in primary care with sore throat.
"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."
Hayward, G. N. et al. Effect of Oral Dexamethasone Without Immediate Antibiotics vs Placebo on Acute Sore Throat in Adults. JAMA 18 April 2017; doi: 10.1001/jama.2017.3417
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