| Study characteristics |
| Methods |
Randomised, double‐blind, placebo‐controlled trial in an emergency department setting in the USA. Follow‐up until resolution of pain; longest contact with participant for follow‐up was 124 hours. |
| Participants |
92 participants (46 in each group) aged 14 to 65 years (mean 29.1 years) presenting with symptoms of sore throat or odynophagia, dysphagia, fever, or cervical lymphadenopathy and appearances of exudative pharyngitis |
| Interventions |
Dexamethasone 2 mL IM (8 mg is an approximate dosage based on USA formularies) or saline 2 mL IM. Antibiotics given to all participants. 1.2 million units benzathine penicillin IM or a 10‐day course of erythromycin 500 mg twice daily |
| Outcomes |
Reduction in pain VAS. Time to onset of pain relief. Time to complete pain resolution. Days missed from school/work. Percentage recurrence |
| Notes |
Analgesia unrecorded and unregulated. Funding source/declaration of interest: not declared. No contact with study authors. |
| Risk of bias |
| Bias |
Authors' judgement |
Support for judgement |
| Random sequence generation (selection bias) |
Low risk |
Randomised list for assignment of participants |
| Allocation concealment (selection bias) |
Unclear risk |
Not specifically commented upon |
| Blinding (performance bias and detection bias)
All outcomes |
Low risk |
Physician and participant blinded to the study drug used. Follow‐up phone calls made by blinded individuals. |
| Incomplete outcome data (attrition bias)
All outcomes |
Low risk |
No losses to follow‐up |
| Selective reporting (reporting bias) |
Low risk |
All outcomes reported. |
| Comparability of groups at baseline |
Low risk |
Comparable |
