From the Guidelines
Dexamethasone should not be used as a first-line treatment for laryngitis in adults due to the lack of evidence supporting its efficacy and the potential for significant side effects. The use of corticosteroids, including dexamethasone, for empiric treatment of dysphonia or laryngitis is discouraged by clinical guidelines 1 due to the overwhelming lack of supporting data. According to a systematic review, there are no studies that support the use of corticosteroids as empiric therapy for dysphonia except in special circumstances 1.
Some of the potential side effects of corticosteroids include insomnia, gastrointestinal disturbances, mood disturbances, obesity, metabolic syndrome, lipodystrophy, and increased cardiovascular risks 1. Long-term use of oral glucocorticoids is also associated with an increased risk of hip/femur fracture, cataract formation, adrenal insufficiency, diabetes, and changes in bone density 1.
Key points to consider when evaluating the use of dexamethasone for laryngitis in adults include:
- The lack of evidence supporting its efficacy for this condition 1
- The potential for significant side effects, even with short-term use 1
- The importance of examining the larynx before initiating treatment 1
- The need for alternative treatments, such as voice rest, adequate hydration, and avoiding irritants 1
In general, the use of dexamethasone for laryngitis in adults should be avoided due to the potential risks and lack of evidence supporting its efficacy 1.
From the Research
Single Dose Dexamethasone for Laryngitis in Adults
- The use of single dose dexamethasone for laryngitis in adults has been studied in various contexts, including its efficacy as an adjuvant therapy for acute pharyngitis 2, 3.
- A study published in 2002 found that a single dose of dexamethasone, either intramuscular or oral, significantly reduced pharyngeal inflammatory pain in patients with acute pharyngitis 2.
- Another study published in 2008 found that a single dose of intramuscular dexamethasone (8 mg) provided relief of symptoms in acute exudative pharyngitis, with a shorter time to onset of pain relief and time to complete relief of pain compared to placebo 3.
- However, a study published in 1966 found that the use of dexamethasone in the treatment of acute laryngotracheitis did not warrant routine use due to the risks inherent in steroid therapy, despite showing some significant differences in clinical parameters 4.
- It is worth noting that the studies mentioned above were focused on pharyngitis or laryngotracheitis, rather than specifically on laryngitis, but the findings may still be relevant to the treatment of laryngitis in adults.
- There is limited direct evidence on the use of single dose dexamethasone for laryngitis in adults, and more research may be needed to fully understand its efficacy and safety in this context 5, 6.