© 2000 Evidence-Based Medicine
Review: glucocorticoids improve symptoms of croup within 6 hours
Ausejo M, Saenz A, Pham B, et al.The effectiveness of glucocorticoids in treating croup: meta-analysis.BMJ 1999 Sep 4;319:595–600
QUESTION: In children with croup, what is the effectiveness of glucocorticoids on croup severity, length of hospital stay, and need for additional interventions?
Studies were identified by searching Medline (1966 to August 1997), EMBASE/Excerpta Medica (1974 to August 1997), and the Cochrane Library Controlled Trials Register. Authors of trials published in the past 5 years were contacted.
Studies were selected if they were randomised controlled trials of glucocorticoids compared with placebo or another active treatment in patients with croup and if clinically relevant outcome measures were used (clinical score, length of hospital stay, or need for additional interventions).
Data were extracted on patient characteristics, details about the intervention and control, and outcomes. The main outcome measure was improvement from baseline croup score. Additional outcomes were length of stay in the hospital or emergency department, rate of hospitalisation, and use of additional interventions.
24 studies were included; 19 were placebo controlled. Age ranged from 4 months to 12 years (mean range 13 to 45 mo). 17 trials evaluated dexamethasone, 9 evaluated budesonide, and 3
St Josefskrankenhaus Freiburg, Germany
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