Dexamethasone, a steroid drug, is used to reduce inflammation and swelling, resulting in less pain. Doctors have long debated whether dexamethasone helps children with throat or ear infections, making them feel better sooner. The answer is, "Yes and no."
The "Yes" answer is for pharyngitis (throat infections). Children with moderate to severe acute pharyngitis who, in addition to antibiotics if needed, were treated with dexamethasone, began to experience less pain sooner than children who didn't receive the steroid.
For those started on dexamethasone, pain reduction began in just under ten hours compared to almost 17 hours for the children not on steroids. Eighty percent of the children on steroids were pain free within 48 hours of starting the medicine while only 60% of the children not on steroids were pain free within the same time period.
The "No" answer applies to children with ear infections. The time it took to experience a reduction in ear pain was the same whether the children were on the steroid or not. Interestingly, the use of antihistamines also had no affect on the children's pain and significantly prolonged the amount of time fluid remained behind their ear drums.
The debate on the appropriate use of steroids will not end soon. Overuse can lead to potentially serious side effects including kidney and adrenal problems. Caution must be exercised when prescribing this class of medicine.
Family Practice News, 11/15/03
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