Oral Dexamethasone for Sore Throat in Adults
The Article: Hayward, Gail Nicola, et al. “Effect of Oral Dexamethasone Without Immediate Antibiotics vs Placebo on Acute Sore Throat in Adults: A Randomized Clinical Trial.” Jama 317.15 (2017): 1535-1543.
The Idea: Compare oral dexamethasone versus placebo to determine if one-time dose of 10mg dexamethasone in the primary care setting can result in total resolution of symptoms at 24 or 48 hours. Key metric was complete resolution at 24 hours with complete resolution at 48 hours as a secondary outcome.
The Study: Adult primary care visits for sore throat in South and West England were randomized to receive either 10mg of oral dexamethasone or placebo and record symptoms with follow-up phone calls and symptom diaries.
The Findings: Dexamethasone treatment group had a slightly higher complete resolution of symptoms at 48 hours (35.4% vs. 27.1%). Based on sample size of 565 eligible randomized patients, the difference was significant only at 48 hours for all patients and patients who did not receive delayed antibiotics. At 24 hours, complete resolution of symptoms was not significant between the 2 groups (22.6% with dexamethasone vs 17.7% for placebo). Patients receiving the medication and placebo had similar rates of adverse effects.
The Takeaway: For adults presenting to a primary care setting with acute sore throat, single-dose 10mg oral dexamethasone is superior for complete resolution of symptoms at 48 hours.