RT Journal
A1 Roy M, Bailey B, Amre DK, Girodias J, Bussières J, Gaudreault P
T1 Dexamethasone for the treatment of sore throat in children with suspected infectious mononucleosis: A randomized, double-blind, placebo-controlled, clinical trial
JF Archives of Pediatrics & Adolescent Medicine
JO Archives of Pediatrics & Adolescent Medicine
YR 2004
FD March 1
VO 158
IS 3
SP 250
OP 254
DO 10.1001/archpedi.158.3.250
UL http://dx.doi.org/10.1001/archpedi.158.3.250
AB Objective 
    To evaluate the efficacy of a single oral dose of dexamethasone for pain relief in acute exudative pharyngitis associated with infectious mononucleosis.Methods 
    We conducted a randomized, double-blind, placebo-controlled pediatric emergency department–based clinical trial. Patients aged between 8 and 18 years with a sore throat from clinically suspected infectious mononucleosis were eligible. Patients were randomized to receive either an oral dose of 0.3 mg/kg (maximum, 15 mg) of dexamethasone or a placebo. Patients completed a diary of symptoms and rated their pain on a visual analog scale from 0 to 100 mm at 0 hours, 12 hours, 24 hours, 48 hours, 72 hours, and on day 7. An improvement of 20 mm from baseline on the visual analog scale was evaluated as the primary end point.Results 
    Twenty patients were recruited in each group; mean ± SD age was 13.5 ± 2.8 years. In comparison with the placebo group, a significantly greater proportion of patients given dexamethasone achieved pain relief within the first 12 hours (12/20 vs 5/19; P = .03). On further follow-up, the proportions achieving pain relief were similar between groups: 11 of 20 vs 6 of 20 at 24 hours (P = .10); 11 of 20 vs 11 of 20 at 48 hours (P>.99); 15 of 20 vs 15 of 19 at 72 hours (P = .93); and 18 of 19 vs 19 of 20 at day 7 (P>.99), with dexamethasone vs placebo, respectively.Conclusions 
    The short-lived relief of pain in acute exudative pharyngitis in children with suspected infectious mononucleosis may suggest that a single oral dose of dexamethasone may not be sufficient and that additional doses may be necessary for ensuring lasting relief.