The conventional therapy of croup, particularly in cases severe enough to require hospitalization, includes parenteral dexamethasone. Earlier trials showed that administration of nebulized budesonide in the emergency department decreases the symptoms of croup more rapidly than placebo and reduces the likelihood of hospitalization. A double-blind, randomized trial compared the effect of nebulized budesonide, intramuscular dexamethasone, and placebo in children with croup. The children were assessed before treatment and then hourly for 5 hours after treatment. The characteristics of the children in each group were similar as to types of viruses identified, types of croup, and clinical severity of the illness.
Intramuscular dexamethasone is it.
For details of the croup scoring system and the rest of the study see the Aug 20 '98 New England Journal of Medicine p498. Complete the post-test. To receive CME credit for this activity, answer the questions on the CME Credit Post-test Page.