Steroids ineffective for pain in children with pharyngitis

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Steroids ineffective for pain in children with pharyngitis

J Fam Pract. 2003 August;52(8):587-604

By

Marc R. Via, MD

BACKGROUND: Dexamethasone has been shown to be beneficial in several pediatric illnesses such as croup and asthma, and intraoperatively for adenotonsillectomy. Several studies of adults with acute pharyngitis reported relief of pain with use of corticosteroids. This study compared whether dexamethasone relieved pain from pharyngitis with group A -hemolytic streptococcus and non–group A -hemolytic streptococcus in children presenting to an emergency room in Canada.
POPULATION STUDIED: The 184 children (aged 5 to 16 years) in this study presented to an emergency room with a chief complaint of sore throat, odynophagia, or dysphagia that began within the preceding 48 hours. They also had demonstrable erythema of the pharynx on exam. Children were excluded if they were immunocompromised, pregnant, already taking antibiotics, had used a corticosteroid recently, or had a peritonsillar or pharyngeal abscess.
STUDY DESIGN AND VALIDITY: This was a randomized, double-blind, placebocontrolled study. Initial allocation to treatment groups was concealed.
OUTCOMES MEASURED: The primary outcome measures were the time to initial pain relief and the time to complete pain relief.
RESULTS: Oral dexamethasone decreased the time to initial pain relief in children who tested positive for group A -hemolytic streptococcus, but not the time to complete pain relief. The mean time to initial pain relief in this group of children was 6 hours in the dexamethasone group vs 11.5 hours in the placebo group (P=.02; effect size of 5.5 hours; 95% confidence interval, 1–10 hours). The time to complete pain relief was approximately 1.5 days in either group. There was no significant difference in either time to initial pain relief or time to complete pain relief in children who tested negative for group A -hemolytic streptococcus.

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Steroids ineffective for pain in children with pharyngitis

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