Characteristics of the Included Randomized Controlled Trials in Adults
| Study, Year, Country | Setting (n) | Mean Age, y | Interventiona | Co-Intervention | Bacteriology | Main Outcomes | Main Results | Authors’ Conclusions |
|---|---|---|---|---|---|---|---|---|
| Exp=experimental; GABHS=group A β-hemolytic streptococci, IM=intramuscular; VAS=visual analogue scale. | ||||||||
| a All control groups received placebo. | ||||||||
| O’Brien et al,9 1993, USA | Educational (51) | 26.4 | 0 mg dexamethasone IM | Antibiotic: yes Analgesic: permitted, controlled | None | 15-cm VAS (0–3.0) pain score at 24 h Time until onset of pain relief Time to complete pain relief | 6.1-h earlier onset of pain relief (6.3 h vs 12.4 h; P=.01) 20.4-h earlier pain free (15 h vs 35.4 h; P = .02) in the steroid arm | “IM dexamethasone appears effective as an adjuvant to antibiotic therapy“ |
| Marvez-Valls et al,7 1998, USA | Educational (92) | 29.2 | 12 mg beta-methasone IM | Antibiotic: yes Analgesic: permitted, not controlled | In 77 of 92 patients done | 10-cm VAS pain score at 24 h and 48 h Change in pain score at 24 h and 48 h Time until onset of pain relief Time to complete pain relief | 5-h earlier onset of pain relief (6.3 h vs 11.3 h; P=.005), 13.8-h earlier pain free (42.0 h vs 55.8 h; P = .013) in the steroid arm If GABHS positive: 28.2-h earlier pain free (28.8 h vs 57.0 h; P=.024) in the steroid arm | “As an adjunct to antibiotic therapy, betamethasone appears to lessen time to relief of pain…most effective in streptococcal-positive pharyngitis” |
| Wei et al,8 2002, USA | Educational (118) | 28.1 | 10 mg dexamethasone IM/oral | Antibiotic: yes Analgesic: permitted, controlled | Yes | Change in 10-cm VAS pain score after 12 h and 24 h Time until onset of pain relief Time to complete pain relief | 4-h earlier onset of pain relief (5.8 h IM/6 h oral vs 10.1 h placebo; P = .029) in the steroid arm | “Dexamethasone at a 10-mg …, significantly contributes to relief of pain” |
| Kiderman et al,6 2005, Israel | General practice (79) | 33.9 | 60 mg prednisone oral 1 or 2 d | Antibiotic: yes Analgesic: permitted, controlled | In 73 of 79 patients done | 10-cm VAS pain score at 12 h, 24 h, 48 h, 72 h | Pain reduction at 12 h (3.9 vs 5.9 P <.001) and 24 h (2.4 vs 4.5; P=.002) in the steroid arm | “…adjuvant oral steroid therapy appears to be safe and more effective than placebo for symptom relief“ |
| Tasar et al,10 2008, Turkey | Educational (73) | 31.3 | 8 mg dexamethasone IM | Antibiotic: yes Analgesic: permitted, not controlled | None | Time until onset of pain relief Time to complete pain relief | 11.8-h earlier onset of pain relief (8.1 h vs 19.9 h; P <.001) 24.8-h earlier pain free (28.9 h vs 53.7 h; P <.001) in the steroid arm | “Single dose…dexamethasone therapy added to the standard treatment has a more rapid improvement of pain” |