Dexamethasone for the Treatment of Sore Throat in Children with Suspected Infectious Mononucleosis: A Randomized, Double-blind, Placebo-Controlled, Clinical Trial

Michel Roy, Benoit Bailey, Devendra K. Amre, Jean Bernard Girodias, Jean François Bussières, Pierre Gaudreault

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)250-254
Number of pages5
JournalArchives of Pediatrics and Adolescent Medicine
Volume158
Issue number3
DOIs
StatePublished - Mar 2004
Externally publishedYes

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Infectious Mononucleosis
Pharyngitis
Controlled Clinical Trials
Dexamethasone
Placebos
Pain
Visual Analog Scale
Therapeutics
Hospital Emergency Service
Clinical Trials
Pediatrics

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Dexamethasone for the Treatment of Sore Throat in Children with Suspected Infectious Mononucleosis : A Randomized, Double-blind, Placebo-Controlled, Clinical Trial. / Roy, Michel; Bailey, Benoit; Amre, Devendra K.; Girodias, Jean Bernard; Bussières, Jean François; Gaudreault, Pierre.

In: Archives of Pediatrics and Adolescent Medicine, Vol. 158, No. 3, 03.2004, p. 250-254.

Research output: Contribution to journalArticle

Roy, Michel ; Bailey, Benoit ; Amre, Devendra K. ; Girodias, Jean Bernard ; Bussières, Jean François ; Gaudreault, Pierre. / Dexamethasone for the Treatment of Sore Throat in Children with Suspected Infectious Mononucleosis : A Randomized, Double-blind, Placebo-Controlled, Clinical Trial. In: Archives of Pediatrics and Adolescent Medicine. 2004 ; Vol. 158, No. 3. pp. 250-254.
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abstract = "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.",
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