Oral Dexamethasone for Mild Croup
Emily M. Herzberg
Lauren Allister
A Randomized Trial of a Single Dose of Oral Dexamethasone for Mild Croup
Bjornson CL, Klassen TP, Williamson J, et al. N Engl J Med. 2004;351(13):1306–1313
Background
Croup (acute laryngotracheobronchitis) is a common presenting complaint in the emergency department (ED). 60% of these children have mild symptoms (barking cough and no stridor at rest) and can be discharged without treatment given an expected uncomplicated course. Previous studies evaluating oral corticosteroid use focused on children with moderate-to-severe symptoms of croup. This study aimed to assess the benefits of corticosteroids in mild disease.
Objectives
To evaluate the benefits of a single dose of oral dexamethasone in children with mild croup.
Methods
Double-blind, randomized, placebo-controlled trial in 4 pediatric EDs in Canada from 2001 to 2003.
Patients
720 children ages 1 to 5 years with mild croup (onset of barking cough within previous 72 hours and score <2 on the Westley croup scale).1 Select exclusion criteria: alternative cause of stridor, chronic lung disease, systemic disease, immune dysfunction, or recent treatment with corticosteroids.
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