THE ROLE OF BETAMETHASONE IN THE TREATMENT OF ACUTE EXUDATIVE PHARYNGITIS

Objective: To compare betamethasone with placebo as an adjuvant to ant ibiotic therapy in the treatment of acute exudative pharyngitis. Metho ds: The study was a randomized, doubled-blind, placebo-controlled, sin gle-center, parallel, outpatient clinical trial. After consent was obt ained, each patient was asked to rate his or her pain on a 10-cm numbe red visual analog scale (VAS; 0-10). All of the patients received inje ctable benzathine penicillin. If allergic to penicillin, they were sta rted on a 10-day course of polyenteric-coated erythromycin (PCE). Each patient was randomized to receive either IM betamethasone or IM place bo. All patients were contacted by telephone at 24 and 48 hours by one of the study investigators and asked to rate their pain based on anot her VAS. If their pain was not resolved by 48 hours, they were called again daily between the third and seventh days after the initial visit to determine the time of pain resolution. Results: A total of 92 pati ents were enrolled in the study, with 46 randomized to receive placebo and 46 to receive betamethasone. Eight patients were excluded from th e statistical analysis because of inability to obtain follow-up. Demog raphic comparison showed that gender distributions, ages, mean initial pain scores, mean times to the first and second follow-up calls, and treatment regimens were similar in the 2 groups. There were significan tly better pain scores for the betamethasone group at first follow-up (p = 0.0005), at second followup (p = 0.004), and in number of hours u ntil relief of pain (p = 0.004). When only those patients with a posit ive culture for a streptococcus species were analyzed, there also were significant reductions in pain score at the first (p = 0.006) and sec ond (p = 0.02) follow-up visits. Conclusion: Pain relief was greater a nd more rapid in patients treated with betamethasone as an adjuvant th erapy in acute exudative pharyngitis.