Dexamethasone for Streptococcal Pharyngitis in Children

Guideline Recommendation

• The Infectious Diseases Society of America (IDSA) guidelines state that adjunctive therapy with a corticosteroid is not recommended for group A streptococcal (GAS) pharyngitis (weak recommendation, moderate quality evidence) 1, 2
• The IDSA recommends primary treatment with an appropriate antibiotic, such as penicillin or amoxicillin, for streptococcal pharyngitis 3
• For symptom management, the IDSA recommends acetaminophen or NSAIDs as adjunctive therapy for moderate to severe symptoms or high fever (strong recommendation, high quality evidence) 1, 2

Important Caveats

• The IDSA guideline recommendation against corticosteroids reflects concerns about routine use without clear evidence of impact on clinically important outcomes (complications, school/work absence) 1, 2
• Aspirin should be avoided in children with streptococcal pharyngitis 1, 2