In Children with Moderate to Severe Croup, is Steroid Therapy Effective in Reducing Acute Symptom?
• The argument of using corticosteroids in treating viral croup started in 1970s. However this question has been addressed by 2 meta-analyses.8,9 The meta-analysis by Kairys et al included 9 RCT involving hospitalized cases (n=1286) and found significant improvement at 12 and 24 hours after steriod therapy. The other one by Ausejo et al included 24 RCTs (14 on in-patients and 10 on out-patients, n=1736) also favored steroid treatment (irrespective of the route of administration) in improving the croup score at 6 and 12 hours, reducing the need of adrenaline treatments, decreasing A&E attendance and hospital length of stay. • Three RCTs10-12 had shown that one single dose of oral or intramuscular steroids reduced croup score, hospital admission by 75% and re-attendance rate after discharge by 70%. • – One RCT13 involving 120 children had shown that 0.15 mg/kg oral dexamethasone was as effective as 0.6 mg/kg. However those children on lower dose were more likely to receive nebulized adre
