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Steroid Eases Pain of Severe Sore Throats

Study finds one dose of dexamethasone brings relief

WEDNESDAY, Jan. 9, 2002 (HealthDayNews) -- Researchers at the Mayo Clinic have discovered a powerful painkiller for one of the most common ailments plaguing Americans: the sore throat.

A new study that appears in the January issue of the journal Laryngoscope found that just one 10-milligram dose of the steroid dexamethasone dramatically eased the pain of sore throats in patients over the age of 15.

Steroids are only available by prescription, so sore-throat sufferers will still have to see their doctor to take advantage of this finding.

Children who have tonsilectomies are routinely treated with steroids to reduce nausea and vomiting. However, Dr. Julie L. Wei, lead researcher on the study, noticed these same kids also seemed to experience less throat pain.

"Not only did they have less nausea and vomiting, but they could all eat the same day," she explains.

Wei set out to see whether the same would hold true for routine sore throats. Over the course of two years, she and her colleagues from the Mayo Clinic in Rochester, Minn., looked at 118 patients who had gone to a Mayo Clinic emergency room complaining of a severe sore throat.

The study design was simple: Each patient was asked to rate their pain on a scale of one to 10, throat cultures were taken to determine if the infection was bacterial, and all the patients were prescribed antibiotics. Study participants were then divided into two groups: Half were given a single dose of dexamethasone, either in injection or pill form; the rest were given a placebo, also in either shot or pill form.

The vast majority of patients were reached by telephone later, and asked to rate their pain 12 hours and 24 hours after the initial treatment. Sixty-seven percent of patients who had received the steroid treatment returned to normal activity within 12 hours, compared with 33 percent of the placebo population. A full 84 percent of the steroid patients returned to normal activity in 24 hours, compared with only 50 percent of the placebo patients. On average, patients who received dexamethasone reported relief from pain four hours sooner than those who received the placebo. No one complained of side effects.

There's no scientific evidence as to why steroids have this effect, Wei says, but the drugs may ease pain by simply reducing the inflammation and swelling that accompanies many sore throats.

While the steroid reduced pain, it did not take care of any underlying infection -- that was the role of the antibiotic.

"The steroid is not going to treat the infection per se," says Wei. "This is looking at the pain issue. The ultimate endpoint of treatment is how to effect the relief of pain."

The steroid helped everyone, regardless of whether they had a viral or bacterial infection, but researchers did notice that those with bacterial infections had a more dramatic recovery.

Heartening as the results were, Wei emphasizes steroids should be reserved for patients who have severe symptoms.

"I get calls where people say, 'If I wake up with a minor sore throat in the middle of the night, should I be hounding down the doctor?' The answer is no," says Wei. "This is not your typical minor sore throat. This is a sore throat that is severe enough to make you go to the emergency room."

What To Do

Because antibiotics may be necessary if the infection is bacterial, anyone with a severe sore throat should contact their doctor or visit an emergency room. It's especially important to receive treatment for strep throat, which can have dangerous complications if left untreated.

Diabetics should not take steroids, as they will alter blood sugar. A one-time dose of a steroid probably won't have any side effects in a healthy person.

For more information on sore throats, visit Achoo.

Check out the details on dexamethasone.

SOURCES: Interview with Julie L. Wei, M.D., fellow, pediatric ontolaryngology, Children's Memorial Hospital, Chicago; January 2002 Laryngoscope
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