In many ways, steroids are wonder drugs. They help with pain, swelling, and inflammation. They are the mainstay in treating many problems including asthma and allergies. But they have a downside. When used inappropriately or in excess, they can cause many problems.
Dexamethasone is a steroid commonly used to treat children who need this type of drug. Many doctors believe it helps lessen the pain of pharyngitis (sore throat).
To determine if dexamethasone really helps, doctors at Texas A & M College of Medicine treated half of 184 children seen in their emergency department for sore throats with dexamethasone and other medications, such as antibiotics. The other half received a placebo plus routine medicines.
The success of treating with dexamethasone depended on whether or not the child had a strep throat. For children with a sore throat caused by beta-hemolytic streptococcus (the technical name for the bacterium that causes strep throat) treated with dexamethasone, the average time for the pain to begin to go away was six hours. The child with a strep throat not treated with dexa-methazone took an average of 11.5 hours for initial pain relief. In all the children, it took an average of one and a half days for the pain to completely go away.
For the children who have a viral sore throat, dexamethasone actually increased the time to initial pain relief. It took 13 hours for those who received the dexamethasone compared to nine hours for those who didn't. In all the children with viral sore throats, it took about two days for the pain to go away.
The reseachers concluded that although dexamethasone does offer some relieve to children with true strep throat, in the long term it makes no difference. Using this drug produced results that were "of marginal clinical importance."
Annals of Emergency Medicine, 5/03
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