From the Guidelines
For a 58 lb (26.3 kg) child with pharyngitis, the recommended dose of dexamethasone is 0.5 mg/kg, which equals approximately 13.15 mg, as most published studies used this dose and found it effective in reducing pain and swelling 1. This dose can be administered orally or by intramuscular injection, with the oral route generally preferred for children when possible. The mechanism of efficacy of dexamethasone is unknown but may be related to its anti-inflammatory properties that reduce pain and swelling 1. Some studies suggest that lower doses may be equally effective, with a range of 0.15 to 1.00 mg/kg, but 0.5 mg/kg is the most commonly used dose 1. Dexamethasone helps reduce inflammation and pain associated with pharyngitis, potentially shortening symptom duration. It's particularly useful for severe cases where pain is limiting oral intake or causing significant discomfort. Side effects are minimal with a single dose, but may include increased appetite, mood changes, or stomach upset. Dexamethasone should be used cautiously in children with diabetes, as it can raise blood glucose levels 1. It's essential to note that dexamethasone does not treat the underlying cause of pharyngitis, so appropriate antibiotic therapy should be given if bacterial infection is confirmed or suspected. Key points to consider when administering dexamethasone to a child with pharyngitis include:
- The dose should not be repeated for the same illness episode
- The child should be monitored for potential side effects
- Appropriate antibiotic therapy should be given if bacterial infection is confirmed or suspected
- Dexamethasone can be beneficial in reducing pain and swelling, but its use should be cautious in children with certain comorbidities, such as diabetes 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Dexamethasone Dosage for Pharyngitis in a 58 lb Child
- The recommended dosage of dexamethasone for pharyngitis in children is 0.6 mg/kg, with a maximum dose of 10 mg 2, 3.
- To calculate the dosage for a 58 lb child, first convert the weight from pounds to kilograms: 58 lb / 2.2 lb/kg = 26.4 kg.
- Then, calculate the dosage: 0.6 mg/kg x 26.4 kg = 15.8 mg.
- However, since the maximum recommended dose is 10 mg, the child should not exceed this amount 2, 3.
- It is essential to note that the use of steroids in acute ENT infections, including pharyngitis, is not widely supported by clinical data, except for cases of acute laryngitis in children 4.
- Some studies suggest that a single dose of dexamethasone can provide faster pain relief and shorter duration of sore throat in children with moderate to severe pharyngitis 2, 5, 3.