Bulloch et al,11 2003, USA | Educational (184) | 9.7 | 10 mg dexamethasone oral | Antibiotic: yes if rapid antigen test positive for GABHS
Analgesic: permitted, not controlled | Yes | 10-cm VAS pain score at 24 h Change in pain score at 24 h
Time until onset of pain relief
Time to complete pain relief | If GABHS positive: 5.5 h earlier onset of pain relief (6.0 h vs 11.5 h; P = .02) in the steroid arm | “…oral dexamethasone does not decrease the time to onset of clinically significant pain relief or the time to complete pain relief” |
Olympia et al,12 2005, USA | Educational (125) | 11.4 | Maximum 10 mg dexamethasone (0.6 mg/kg) oral | Antibiotic: yes if rapid antigen test positive for GABHS
Analgesic: permitted, | Yes | Change in McGrath Facial Affective scale pain score at 24 h and 48 h
Time until onset of pain relief
Time to complete pain relief | If GABHS positive: 5.1 h (95% CI, 0.5–10.8 h) earlier onset of pain relief (9.7 h vs 14.8 h) in the steroid arm | “Immunocompetent children with moderate to severe pharyngitis benefited from the use of oral dexamethasone” |
Niland et al,13 2006, USA | Educational (84) | 8b | Maximum 10 mg dexamethasone (0.6 mg/kg) oral, 1 or 3 d | Antibiotic: yes
Analgesic: permitted, controlled | Yes | Time until onset of pain relief
Time improvement of general condition
Time to improvement of activity level in days | 1 d earlier onset of pain relief (1 d vs 2 d) in the steroid arm | “…children with acute uncomplicated GABHS pharyngitis who receive steroids as add-on treatment are likely to convalesce faster” |