Table 1.

Characteristics of the Included Randomized Controlled Trials in Adults

Study, Year, Country	Setting (n)	Mean Age, y	Interventiona	Co-Intervention	Bacteriology	Main Outcomes	Main Results	Authors’ Conclusions
O’Brien et al,9 1993, USA	Educational (51)	26.4	0 mg dexamethasone IM	Antibiotic: yes Analgesic: permitted, controlled	None	15-cm VAS (0–3.0) pain score at 24 h Time until onset of pain relief Time to complete pain relief	6.1-h earlier onset of pain relief (6.3 h vs 12.4 h; P=.01) 20.4-h earlier pain free (15 h vs 35.4 h; P = .02) in the steroid arm	“IM dexamethasone appears effective as an adjuvant to antibiotic therapy“
Marvez-Valls et al,7 1998, USA	Educational (92)	29.2	12 mg beta-methasone IM	Antibiotic: yes Analgesic: permitted, not controlled	In 77 of 92 patients done	10-cm VAS pain score at 24 h and 48 h Change in pain score at 24 h and 48 h Time until onset of pain relief Time to complete pain relief	5-h earlier onset of pain relief (6.3 h vs 11.3 h; P=.005), 13.8-h earlier pain free (42.0 h vs 55.8 h; P = .013) in the steroid arm If GABHS positive: 28.2-h earlier pain free (28.8 h vs 57.0 h; P=.024) in the steroid arm	“As an adjunct to antibiotic therapy, betamethasone appears to lessen time to relief of pain…most effective in streptococcal-positive pharyngitis”
Wei et al,8 2002, USA	Educational (118)	28.1	10 mg dexamethasone IM/oral	Antibiotic: yes Analgesic: permitted, controlled	Yes	Change in 10-cm VAS pain score after 12 h and 24 h Time until onset of pain relief Time to complete pain relief	4-h earlier onset of pain relief (5.8 h IM/6 h oral vs 10.1 h placebo; P = .029) in the steroid arm	“Dexamethasone at a 10-mg …, significantly contributes to relief of pain”
Kiderman et al,6 2005, Israel	General practice (79)	33.9	60 mg prednisone oral 1 or 2 d	Antibiotic: yes Analgesic: permitted, controlled	In 73 of 79 patients done	10-cm VAS pain score at 12 h, 24 h, 48 h, 72 h	Pain reduction at 12 h (3.9 vs 5.9 P <.001) and 24 h (2.4 vs 4.5; P=.002) in the steroid arm	“…adjuvant oral steroid therapy appears to be safe and more effective than placebo for symptom relief“
Tasar et al,10 2008, Turkey	Educational (73)	31.3	8 mg dexamethasone IM	Antibiotic: yes Analgesic: permitted, not controlled	None	Time until onset of pain relief Time to complete pain relief	11.8-h earlier onset of pain relief (8.1 h vs 19.9 h; P <.001) 24.8-h earlier pain free (28.9 h vs 53.7 h; P <.001) in the steroid arm	“Single dose…dexamethasone therapy added to the standard treatment has a more rapid improvement of pain”

Exp=experimental; GABHS=group A β-hemolytic streptococci, IM=intramuscular; VAS=visual analogue scale.

^a All control groups received placebo.