Why dexamethasone for croup

Noninferiority was demonstrated for both low-dose dexamethasone and prednisolone. The type of oral steroid seems to have no clinically significant impact on efficacy, both acutely and during the week after treatment. MMWR Morb. We have detected that you are using an Ad Blocker. PracticeUpdate is free to end users but we rely on advertising to fund our site. Please consider supporting PracticeUpdate by whitelisting us in your ad blocker. We have sent a message to the email address you have provided,.

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Intramuscular corticosteroids are typically used when intravenous and oral administration are not feasible. Based on expert opinion and consensus, dexamethasone is the recommended corticosteroid for treatment of croup because of its longer half-life a single dose provides anti-inflammatory effects over the usual symptom duration of 72 hours. However, no randomized controlled trials have compared multiple versus single dosing.

If continued therapy is required, other causes for airway obstruction or respiratory distress should be considered. No adverse effects have been associated with appropriate corticosteroid therapy in patients with croup. The risks of single-dose corticosteroids are very low, but should be considered in children with diabetes mellitus, children exposed to varicella virus, and children at risk of bacterial superinfection i.

A number of small randomized controlled trials have shown that nebulized epinephrine is an effective treatment for moderate to severe croup, with benefits such as reduction in croup severity, various objective pathophysiologic measures, and need for intubation. Using a nebulizer is equally as effective as using intermittent positive pressure ventilation.

With either form of epinephrine, therapeutic benefit usually occurs within the first 30 minutes. Because this benefit typically lasts up to two hours, it may be best to evaluate for disposition several hours following the last epinephrine treatment.

The rapid action of epinephrine paired with the later onset and sustained action of corticosteroid treatment justifies the consideration of dual therapy. Already a member or subscriber? Log in. Interested in AAFP membership? Learn more. Royal Sr. Todd Jr. Reprints are not available from the authors. Knutson D, Aring A. Viral croup. Am Fam Physician. Croup hospitalizations in Ontario. Cherry JD. Clinical practice.

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Arch Pediatr Adolesc Med. Outpatient treatment of moderate croup with dexamethasone: intramuscular versus oral dosing. Shimmer B. Dexamethasone in Croup : A Controlled Study. Am J Dis Child. Coronavirus Resource Center. Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy Continue.

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