Dexamethasone as adjuvant treatment in patients with acute severe pharyngitis : a descriptive study at Welcare Hospital emergency unit, Dubai, United Arab Emirates

Ishtayeh, Bilal (2014-12)

Thesis (MFamMed)--Stellenbosch University, 2015.


Background: An increased incidence of acute group A ß-hemolytic Streptococcal (GABHS) pharyngitis has been reported anecdotally at the Welcare Hospital in Dubai. Aim: To describe the outcomes of patients with acute GABHS pharyngitis who received standard therapy at the Welcare hospital emergency unit in Dubai. Objectives To determine the time elapsed before patients experience a clinically significant reduction in pain. To describe the side-effect profile of standard treatment received for acute GABHS pharyngitis. Methods: This is a cross-sectional study design. Consecutive sampling of 123 patients was done from December, 2013 to March, 2014. A questionnaire was used to record demographic data and severity of GABHS before patients received standard treatment. The Visual Analogue Scale (VAS) was used to measure pain severity at baseline and during follow-up. Adults diagnosed with GABHS pharyngitis who received dexamethasone as part of standard treatment offered were included. Results: Clinical pain relief, which was suggested as a VAS score of 4, was achieved by 5.7% of the patients at 12 hours. At 24 hours, 55.3% of the patients reported a VAS score of 4. The mean VAS score of the patients at this time was 4.12. A total of 99.2% of the patients reported a VAS score of 4 or lower at 36 and 48 hours. Paired t-test revealed statistically significant difference between the VAS scores at 12, 24, 36 and 48 hours and baseline (p=0.000). This suggests that clinical pain relief was achieved by 55.3% of the patients at 24 hours. At 48 hours, 21.1% of the patients reported a VAS score of 0. None of the patients reported any side effects associated with the one dose use of dexamethasone. Conclusion: The findings suggest that dexamethasone is safe and effective to use as adjuvant for management of pain associated with acute GABHS pharyngitis. Almost all patients experienced significant pain relief by 36 and 48 hours and no side-effects related to dexamethasone use were recorded. Further definitive randomised controlled trials are needed to establish these findings as evidence for practice.


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